Orthopedics - Treatment Of Hip Fracture

Front 1

Hip Fracture: Risk Factors (3)

Back 1

Old age
Metabolic bone disease
Falls

Front 2

Vessels that supply head of femur

Back 2

Retinacular vessels
Ligamentum teres
Intraosseous

Front 3

Intra-capsular fractures: classification

Back 3

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

Front 4

Hip Fracture: symptoms

Back 4

Severe pain
Inability to ambulate

Front 5

Hip Fracture: signs

Back 5

Shortened and externally rotated leg
Guarding

Front 6

Hip Fracture: pre-surgery treatment

Back 6

Admit
Skin traction
Optimize concurrent disease
Plan surgery
Initiate rehabiliation services

Front 7

Hip Fracture: surgical treatment goals (4)

Back 7

pain relief
reduce deformity
promote union
early ambulation

Front 8

Hip Fracture: surgical approaches (3)

Back 8

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

Front 9

Relative indications for primary arthroplasty (4)

Back 9

Displaced subcapital fracture (>70)
Pathological fracture due to tumour
Co-existant arthropathy
Head-splitting fracture (any age)

Front 10

Primary arthroplasty types

Back 10

Hemi-arthroplasty
Total hip arthroplasty

Front 11

Hip Fracture Treatment: local complications (4)

Back 11

Intra-operative injury
Infection
Nonunion
Osteonecrosis

Front 12

Hip Fracture Treatment: regional complications (3)

Back 12

DVT
Decubitus ulcer
Deformity and stiffness

Front 13

Hip Fracture Treatment: systemic complications (6)

Back 13

Pulmonary problems
Confusion
PE
UTI
Death (10-15% in 1st year)
Loss of independance

Front 14

Arthroplasy complications

Back 14

Dislocation
Lossining of prosthesis
Acetabular wear

Front 15

Hip Fracture: prognostic factors (5)

Back 15

Age
Qualityof reduction
Severity of initial fracture
Fixation device
General health

Front 16

Hip Fractures: prevention

Back 16

Bone loss prevention
Home safety (bathtub, carpet, shoes)
Use walking aids
Special garments