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16 Cards in this Set

  • Front
  • Back
Hip Fracture: Risk Factors (3)
Old age
Metabolic bone disease
Falls
Vessels that supply head of femur
Retinacular vessels
Ligamentum teres
Intraosseous
Intra-capsular fractures: classification
Garden I: incomplete fracture, impacted, valgus angulation
Graden II: complete fracture, non-displaced
Garden III*: complete fracture, partially displaced (varus)
Garden IV*: complete fracture, complete displacement
*poor prognosis
Hip Fracture: symptoms
Severe pain
Inability to ambulate
Hip Fracture: signs
Shortened and externally rotated leg
Guarding
Hip Fracture: pre-surgery treatment
Admit
Skin traction
Optimize concurrent disease
Plan surgery
Initiate rehabiliation services
Hip Fracture: surgical treatment goals (4)
pain relief
reduce deformity
promote union
early ambulation
Hip Fracture: surgical approaches (3)
1. Screw fixation: sub-capital fractures, insert with image intensifier, risk of non-union
2. Screw-plate fixation: inter and sub-trochanteric fractures, larger incision and more blood loss, depends on bone strength
3. Primary arthroplasty: definitive, early mobility, limited longevity, infection risk
Relative indications for primary arthroplasty (4)
Displaced subcapital fracture (>70)
Pathological fracture due to tumour
Co-existant arthropathy
Head-splitting fracture (any age)
Primary arthroplasty types
Hemi-arthroplasty
Total hip arthroplasty
Hip Fracture Treatment: local complications (4)
Intra-operative injury
Infection
Nonunion
Osteonecrosis
Hip Fracture Treatment: regional complications (3)
DVT
Decubitus ulcer
Deformity and stiffness
Hip Fracture Treatment: systemic complications (6)
Pulmonary problems
Confusion
PE
UTI
Death (10-15% in 1st year)
Loss of independance
Arthroplasy complications
Dislocation
Lossining of prosthesis
Acetabular wear
Hip Fracture: prognostic factors (5)
Age
Qualityof reduction
Severity of initial fracture
Fixation device
General health
Hip Fractures: prevention
Bone loss prevention
Home safety (bathtub, carpet, shoes)
Use walking aids
Special garments