Podcast
Questions and Answers
What does ORIF stand for in the context of intertrochanteric fractures?
What does ORIF stand for in the context of intertrochanteric fractures?
Which condition is NOT a common indication for hemiarthroplasty?
Which condition is NOT a common indication for hemiarthroplasty?
What is a common cause of posterior hip dislocation?
What is a common cause of posterior hip dislocation?
Which of the following is a complication specifically associated with subtrochanteric fractures?
Which of the following is a complication specifically associated with subtrochanteric fractures?
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What should be avoided to prevent redislocation after an anterior hip dislocation?
What should be avoided to prevent redislocation after an anterior hip dislocation?
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In which situation might a non-displaced femoral fracture be treated without surgery?
In which situation might a non-displaced femoral fracture be treated without surgery?
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How does the rehabilitation program for hip fractures typically progress?
How does the rehabilitation program for hip fractures typically progress?
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Which clinical feature is associated with anterior hip dislocation?
Which clinical feature is associated with anterior hip dislocation?
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What is the typical management for a posterior hip dislocation?
What is the typical management for a posterior hip dislocation?
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What is a primary reason for using hemiarthroplasty?
What is a primary reason for using hemiarthroplasty?
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Study Notes
Intertrochanteric Fractures
- Treated with open reduction and internal fixation (ORIF)
- Allows for early mobility
- Weight-bearing restrictions are present while the fracture heals
- Important to know the patient's weight-bearing status
- Rehabilitation programs are highly individualized
- Consider fracture type, classification, location, and method of internal fixation
- Progression of rehabilitation depends on the rate of bone healing
Hemiarthroplasty
- Replacement of the femoral head
- Indications: subcapital fracture of the femur, degeneration of the femoral head, avascular necrosis (AVN), slipped capital femoral epiphysis, Legg-Calve'-Perthes disease
- Aims to eliminate pain and improve function
- Rarely used to treat osteoarthritis (OA)
Femoral Fractures
- Most fractures will require surgery
- Proximal femoral shaft or subtrochanteric areas are common locations
- Very young children with non-displaced fractures may be treated with casting
- Mechanism of injury: high velocity or impact trauma
Hip Fracture/Dislocations
- Both fractures and dislocations can occur separately or together
- Fractures and dislocations require prompt management
Posterior Hip Dislocation
- Usually a consequence of severe trauma
- Common cause: force on the knee with the hip and knee flexed (dashboard injury)
- May be associated with a fracture of the posterior acetabular wall
- Risk of avascular necrosis
- Patients experience acute pain, unable to bear weight, limb held in flexion and internal rotation
- All movements are painful
Anterior Hip Dislocation
- Mechanism of injury: force at knee with the thigh abducted
- Symptoms: acute pain, inability to bear weight, limb held in flexion and external rotation
Hip Dislocation Treatment
- An emergency situation due to limited blood supply
- Anterior dislocation: bed rest with traction, protected weight-bearing 3-4 weeks after the incident, avoid extreme hip abduction and external rotation
- Posterior dislocation: bed rest and traction in abduction, avoid hip abduction, flexion, and internal rotation
Hip Fracture Key Terms
- Malunion: fracture heals with an angular or rotary deformity
- Delayed union: failure of a fracture to unite within a normal timeframe
- Nonunion: a fracture fails to heal
- Avascular necrosis: blood supply to the bone is compromised causing bone death
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Description
This quiz covers the treatment and rehabilitation strategies for intertrochanteric and femoral fractures. It discusses various treatment options like ORIF and hemiarthroplasty, along with their indications and outcomes. Understand the importance of individualized rehabilitation based on the fracture type and healing progress.
