Y5 - Hip: Fracture (neck of femur, pelvic, pubic ramus) Flashcards Preview

Year 5 Acute Care & Trauma > Y5 - Hip: Fracture (neck of femur, pelvic, pubic ramus) > Flashcards

Flashcards in Y5 - Hip: Fracture (neck of femur, pelvic, pubic ramus) Deck (32)
Loading flashcards...
1
Q

most common cause of a hip fracture

A

a fall

2
Q

risk factors

A

osteoporosis
alcohol use
metastatic cancer
age

3
Q

epidemiology

A

women>men

15% lifetime risk

4
Q

symptoms

A

Hx of a low energy fall
groin pain
unable to weight bare

5
Q

signs

A

referred pain to the supracondylar knee

affected leg is shortened and externally rotated

6
Q

anatomy of the hip

A

the enarthrodial joint (ball and socket) connects to the acetabulum of the pelvis, (which is lined by the labrum)

7
Q

what muscle tendon surrounds the entire joint

A

psoas muscle

8
Q

what three ligaments surround the entire joint

A

iliofemoral ligament located anteriorly which prevents hip hyperextension
pubofemoral ligament located anteriorly but deep to the iliofemoral ligament and resists abduction, extension, and external rotation
ischiofemoral ligament on the posterior side which resists extension, adduction, and internal rotation

9
Q

what ligament resists internal rotation and adduction

A

ischiofemoral ligament

10
Q

what ligament resists external rotation and abduction

A

pubofemoral ligament

11
Q

investigations

A

xray (AP and lateral view)

MRI is next choice of investigation

12
Q

what direction of fall commonly causes a hip fracture

A

a sideways fall

13
Q

what are the two main types of hip fracture

A

intracapsular

extracapsular

14
Q

what are the two ares of intracapsular hip fracture

A
femoral head
femoral neck
-subcapital
-transcervical
-basicervical
15
Q

what are the different types of femoral neck fracture

A

subcapital
transcervical
basicervical

16
Q

what classification system is used for femoral head fractures

A

pipkin classification

17
Q

what classification systems are used for femoral neck fractures

A

garden classification

pauwels classification

18
Q

what are the two types of extracapsular hip fractures

A

tronchanteric

subtrochanteric

19
Q

what are the different types of trochanteric fractures

A

intertrochanteric (between greater and lesser trochanter)

pertrochanteric (through the trochanters)

20
Q

how are intracapsular fractures managed

A

surgery - fixation with in situ screws

with displaced intracapsular fractures - a hemiarthroplasty

21
Q

how are trochanteric fractures managed

A

surgery - dynamic hip screw

22
Q

complications

A

nonunion (failure of the fracture to heal)
malunion (healing in a distorted position)
avascular necrosis is common in intracapsular fractures

23
Q

prognosis

A

one month mortality is 10%

one year mortality is 30%

24
Q

epi

A

women>men
white>blicks
elderly

25
Q

what bones form the pelvis

A

ischium
ilium
pubis

26
Q

how do pelvic fractures occur

A

high-energy trauma (car crash, falls from height)

27
Q

epi of pelvic fractures

A

from major trauma

less severe pelvic fractures are generally in elderly

28
Q

signs of pelvic fractures

A
tenderness, bruising, swelling
haematuria
rectal bleeding
haematoma
instabilty on hip adduction and pain on hip movement
29
Q

what are common classifications for hip fractures

A

Tile

Young-Burgess

30
Q

epi of pelvic fractures

A

from major trauma

less severe pelvic fractures are generally in elderly

31
Q

signs of pelvic fractures

A
tenderness, bruising, swelling
haematuria
rectal bleeding
haematoma
instabilty on hip adduction and pain on hip movement
32
Q

what are common classifications for hip fractures

A

Tile

Young-Burgess