Femoral Neck

Front 1

risk factors associated with increased risk of sustaining a hip fracture

Back 1

BMI <18.5
low sunlight exposure
low recreational activity
smoking
h/o previous osteoporotic fracture
maternal h/o hip fracture
corticosteroid treatment

Front 2

mechanisms of injury

Back 2

fall
external rotation of leg
high energy trauma
stress fracture

Front 3

associated injuries

Back 3

(vast majority are isolated)
distal radius
proximal humerus
ipsilateral femoral shaft

Front 4

femoral neck fracture incidence with a femoral shaft fracture

Back 4

2-6%

Front 5

physical presentation of displaced femoral neck

Back 5

shortened
externally rotated

Front 6

traction?

Back 6

no conclusive benefits in:
pain relief
ease of fracture reduction
quality of reduction

Front 7

laboratory eval and tests

Back 7

CBC with diff
type and screen
BMP
EKG (>60 or heart hx)

Front 8

Garden classification based on

Back 8

AP view, relationships of trabecular lines in femoral head to acetabulum

Front 9

Garden classification

Back 9

I: valgus impacted and retroverted, can be incomplete
II: complete, nondisplaced (no shift in alignment)
III: marked varus angulation, no proximal translation of shaft
IV: complete displacement with shaft shifted proximally (trabecular lines of fem head and acetab realign)

Front 10

Pauwell classification based on

Back 10

plane of fracture (transverse, oblique, vertical)

Front 11

Pauwell classification

Back 11

I: transverse (<30 deg)
II: oblique (30-50 deg)
III: vertical (>50 deg) - younger patients

Front 12

femoral neck angle

Back 12

neck angle with femoral shaft
normal 130-135

Front 13

femoral anteversion

Back 13

angle between femoral neck and transcondylar axis
normal 15-25

Front 14

hip axis length

Back 14

distance from lateral aspect of trochanteric region along femoral neck to inner table of the pelvis

Front 15

measurements associated with increased risk of femoral neck fracture

Back 15

increased hip axis length
femoral neck width
lower neck shaft angle

Front 16

calcar femorale

Back 16

dense vertical plate of bone extending from posteromedial portion of femoral shaft under the lesser trocheter radiation to greater troch and reinforcing posteromedial portion of the femoral neck

Front 17

most important source of femoral head blood supply

Back 17

capsular vessels

Front 18

origin of capsular vessels

Back 18

femoral a --> profunda femoris a --> medial/lateral circumflex femoral a --> ascending cervical capsular vessels

Front 19

retinacular vessels

Back 19

ascending cervical capsular vessels within the capsule

Front 20

most important retinacular vessels

Back 20

deep branch of medial femoral circumflex a
(supply main weight-bearing area of femoral head)
penetrate femoral head 2-4 mm proximal to articular suface on posterosuperior aspect

Front 21

four groups of retinacular vessels

Back 21

anterior
medial
lateral (largest contributor to femoral head)
posterior

Front 22

subsynovial intraarticular ring

Back 22

second ring anastomosis at junction of articular surgace of femoral head and femoral neck

Front 23

sources of femoral head blood supply

Back 23

capsular vessels
intramedullary vessels
contribution from ligamentum teres

Front 24

artery of ligamentum teres arises from

Back 24

obturator or medial femoral circumflex a

Front 25

why see prolonged union times in femoral neck fractures

Back 25

no cambial layer so must heal by endosteal mechanism alone (no callus forms)

Front 26

extent of hip joint capsule

Back 26

extends down to intertrochanteric line over anterior aspect of the femoral neck

Front 27

3 ligamentous stabilizers of the hip

Back 27

ischiofemoral
iliofemoral
pubofemoral

Front 28

ischiofemoral ligament

Back 28

controls internal rotation in flexion and extension

Front 29

lateral arm of iiofemoral ligament

Back 29

external rotation in flexion
internal and external rotation in extension

Front 30

pubofemoral ligament

Back 30

controls external rotation in extension

Front 31

sources of sensation to hip joint

Back 31

obturator
femoral
sciatic
superior gluteal

Front 32

anteromedial part of hip joint innervation

Back 32

obturator

Front 33

anterior capsule innervation

Back 33

femoral n

Front 34

posterior aspect of joint innervation

Back 34

sciatic n

Front 35

posterolateral capsule innervation

Back 35

superior gluteal n

Front 36

hip flexors

Back 36

iliopsoas

Front 37

insertion of iliopsoas

Back 37

lesser trochanter

Front 38

hip external rotators

Back 38

piriformis
gemelli
obturator internus

Front 39

hip abductors

Back 39

gluteal muscles (superior gluteal n)

Front 40

hip adductors

Back 40

adductor longus
adductor magnus
adductor brevis
(all by obturator n)

Front 41

Y ligament of Bigelow

Back 41

iliofemoral ligament

Front 42

capsule attachments

Back 42

anteriorly to intertrochanteric line
posteriorly 1-1.5 cm proximal to intertrochanteric line

Front 43

path of medial femoral circumflex

Back 43

between pectineus and psoas
passes posterior under quadratus

Front 44

path of lateral femoral circumflex

Back 44

passes deep to sartorius and rectus