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Hip Fractures - Coggle Diagram
Hip Fractures
Work up
AP and lateral X-ray
Fast for surgery
Fluids
Routine bloods - FBC, U and E, Coag, G and H
Check medications
Hx
Clinical exam
ECG +/- CXR
+/- CT to r/o occult fracture
+/- full length femur in select circumstances
Epidemiology and Risk Factors
Sex
F:M 3-4:1
Race
Caucasians
Age >65 yrs
Co-morbidities
Osteoporosis
Endocrine disorders
Poor nutritient
Vit D and calcium deficiency
Medication
Steroid
Anticonvulsants
Diuretics
Environmental
poor lighting
Loose rugs
Cluttered floors
Clinical Presentation
Pain
Inability to Weight Bare
Leg held shortened
External rotated
Hx of fall
Associated injuries - fractures elsewherer
Pre-Op management
IV fluids
Regular analgesis
NPO
Anaesthetic r/v
Consented and marked
Orthogeriatric review pre-op multidiciplinary team
X-ray
Shenton's line
Radiological line
Indictaes hip fracture
Lesser Trochanter
Relativity of lesser trochanter to ramus
More visible
Hip Fracture Antomy
Intracapsular
Blood supply often compromised
Hemiarthroplasty
1/2 hip replacement
Replace
Extracapsular
Blood supply prob not compromised
Dynamic hip screw
Fix
Intramedullary nail
Bimodal distribution
Elderly population
Low energy falls
Osteoporotic
Most common presentation
Young Adults
Orthogeriatric Service
Devas (orthopod) and Irvine (geriatrician)
Recognitionof medical complexity
