![]() Being able to identify the type of hip fracture on an x-ray (intra-capsular or extra-capsular) and justify the choice of operation made trauma meetings much less stressful. When I did an FY1 job in trauma and orthopaedics, the juniors were questioned on this concept almost every time a patient with a hip fracture was admitted. TOM TIP: It is worth understanding and remembering the concept of the retrograde blood supply to the head of the femur and how this determines the choice of operation (explained below). Therefore, patients with a displaced intra-capsular fracture need to have the femoral head replaced with a hemiarthroplasty or total hip replacement. A fracture of the intra-capsular neck of the femur can damage these blood vessels, removing the blood supply to the femoral head, leading to avascular necrosis. They provide the only blood supply to the femoral head. Branches of this artery run along the surface of the femoral neck, within the capsule, towards the femoral head. The medial and lateral circumflex femoral arteries join the femoral neck just proximal to the intertrochanteric line. The head of the femur has a retrograde blood supply. It surrounds the neck and head of the femur. It attaches to the rim of the acetabulum on the pelvis and the intertrochanteric line on the femur. The capsule of the hip joint is a strong fibrous structure. There are some basic structures of the top of the femur: Females are affected more often than males.ĭue to the morbidity and mortality with hip fractures, they are generally prioritised on the trauma list with the aim to perform surgery within 48 hours. There is also a specialty called orthogeriatrics, who focus on identifying and optimising the medical co-morbidities and complications of inpatients on the orthopaedic ward, particularly elderly patients with hip fractures. Increasing age and osteoporosis are major risk factors for hip fractures. Half of patients become less independent after a hip fracture. They are common and lead to significant morbidity and mortality. DOI: 10.4081/or.2012.Hip fractures are an important topic in trauma and orthopaedics. ![]() The prognostic value of tip-to-apex distance (TAD index) in intertrochanteric fractures fixed by dynamic hip screw. A comparison of internal fixation and bipolar hemiarthroplasty for the treatment of reverse oblique intertrochanteric femoral fractures in elderly patients. Outcome of the dynamic helical hip screw system for intertrochanteric hip fractures in the elderly patients. Home-based leg strengthening exercise improves function one year after hip fracture: A randomized controlled study. ![]() A biomechanical study comparing helical blade with screw design for sliding hip fixations of unstable intertrochanteric fractures. The stability score of the intramedullary nailed intertrochanteric fractures: Stability of nailed fracture and postoperative patient mobilization. Management of hip fractures in the elderly: Evidence-based clinical practice guideline.
0 Comments
Leave a Reply. |