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16 Cards in this Set
- Front
- Back
Hip Fracture: Risk Factors (3)
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Old age
Metabolic bone disease Falls |
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Vessels that supply head of femur
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Retinacular vessels
Ligamentum teres Intraosseous |
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Intra-capsular fractures: classification
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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 |
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Hip Fracture: symptoms
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Severe pain
Inability to ambulate |
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Hip Fracture: signs
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Shortened and externally rotated leg
Guarding |
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Hip Fracture: pre-surgery treatment
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Admit
Skin traction Optimize concurrent disease Plan surgery Initiate rehabiliation services |
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Hip Fracture: surgical treatment goals (4)
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pain relief
reduce deformity promote union early ambulation |
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Hip Fracture: surgical approaches (3)
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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 |
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Relative indications for primary arthroplasty (4)
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Displaced subcapital fracture (>70)
Pathological fracture due to tumour Co-existant arthropathy Head-splitting fracture (any age) |
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Primary arthroplasty types
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Hemi-arthroplasty
Total hip arthroplasty |
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Hip Fracture Treatment: local complications (4)
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Intra-operative injury
Infection Nonunion Osteonecrosis |
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Hip Fracture Treatment: regional complications (3)
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DVT
Decubitus ulcer Deformity and stiffness |
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Hip Fracture Treatment: systemic complications (6)
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Pulmonary problems
Confusion PE UTI Death (10-15% in 1st year) Loss of independance |
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Arthroplasy complications
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Dislocation
Lossining of prosthesis Acetabular wear |
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Hip Fracture: prognostic factors (5)
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Age
Qualityof reduction Severity of initial fracture Fixation device General health |
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Hip Fractures: prevention
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Bone loss prevention
Home safety (bathtub, carpet, shoes) Use walking aids Special garments |