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19 Cards in this Set
- Front
- Back
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• Where is pain from the hip usually experienced?
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o Anterior groin
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• A patient presents with pain in the buttock. What is the likely source of this pain?
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o Lower back, NOT hip
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• What functional abnormalities are common for patients with hip arthritis?
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o Difficulty putting on socks and shoes, getting out of a chair
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• What is the definitive treatment for arthritis of the hip?
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Hip arthroplasty
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What is the Trendelenberg sign?
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Unable to maintain unilateral stance
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How does a broken hip appear on physical exam?
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Shortened, externally rotated
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How do you treat a femoral neck fracture?
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Non-displaced: internal fixation
Displaced: younger patient -- hemiarthroplasty, older patient -- total arthroplasty |
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What is a "hip fracture"?
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Fracture of the femoral head (capital), femoral neck (subcapital), intertrochanteric region, or region just distal to the femoral trochanters
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What are the two broad categories of hip fracture?
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Intracapsular (head and neck)
Extracapsular (intertrochanteric region, subtrochanteric region) |
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What are the two types of intrapsular hip fracture?
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Fracture of femoral head or neck (subcapital fracture)
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What are the two types of extracapsular hip fractures?
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Intertrochanteric and subtrochanteric
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Describe the pertinent aspects of the blood supply to the femoral neck and head.
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Deep femoral artery gives rise to medial and lateral femoral circumflex arteries, which in turn give rise to the medial lateral ascending cervical arteries.
The cervical arteries travel in a RETROGRADE fashion (distal to proximal) up the femoral neck to supply the neck and head. |
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What is the major complication of an intracapsular hip fracture.
Why does this occur? |
Avascular necrosis of femoral head and neck with impaired wound healing
This occurs because an intracapsular fracture is likely to disrupt the retrograde blood supply to the neck and head. |
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Which type of hip fracture provides the greatest risk for compromise of blood supply to the neck and head with subsequent AVN?
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Intracapsular
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What is the treatment for an intracapsular hip fracture?
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Assumed that blood supply is lost, so Moore's arthroplasty or hemiarthroplasty is the treatment
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What is a Moore's arthroplasty?
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Old-school hemiarthroplasty used in patients with limited life expectancy, sits loose in the joint rather than being cemented in/growing into the bone
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What is a hemiarthroplasty?
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Replacement of the femoral head but not the acetabulum
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In which two scenarios would you not manage an intracapsular fracture with artroplasty and why?
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1) Young patient (<55) because you want to delay a prosthesis that has a limited lifespan
2) Non-displaced fracture because blood supply may be spared |
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What is the treatment of an intracapsular hip fracture in a young patient or a patient with a non-displaced fracture?
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Internal fixation with cannulated screws
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