For femoral neck fractures, the Garden classification is used to differentiate between non-displaced and displaced fractures. The operative management of intertrochanteric and subtrochanteric fractures favours intramedullary nailing. Adequate pain medication, balanced fluid management, delirium prevention and the operative treatment choice based on comorbidities, individual demands and biological rather than chronological age, all deserve particular attention to improve patients’ outcomes. To deal with the exceptional needs of the elderly, the development of orthogeriatric centres to support orthogeriatric co-management is mandatory. Peri-operative management must be handled attentively to avoid complications and decrease mortality rates. This is a result of the demographic change that is expressed by the increasing proportion of elderly people in society. A lucency, representing the fracture, runs between the two trochanters (white arrows).As one of the leading causes of elderly patients’ hospitalisation, proximal femur fractures (PFFs) will present an increasing socioeconomic problem in the near future. There is varus deformityįor a larger photo of the same image without arrows, click on this link (white arrow) and lesser trochanter (red arrow). There are separate fragments of the greater trochanter O Many intertrochanteric fracture are associated with a varus deformityĬomminuted intertrochanteric fracture. O Intertrochanteric fractures associated with a separate fragment of lesser trochanter may also include a portion of the posterior cortex of femoral neck and are considered unstable O Comminuted fractures may also manifest separate fragments of either or both of the lesser and greater trochanters O Most common of the extracapsular hip fractures O May be difficult to differentiate a basicervical fracture from a non-displaced and non-comminuted intertrochanteric fracture O Frequently associated with varus deformity O Usually easy to see on views of the hip obtained in internal rotation On the lateral view, the same step-off can be seen (red arrow) as well as the impaction (white arrow). On the frontal view, there is a step-off in the cortex superiorly (red arrow) while there is abnormal overlapping of the femoral head and neck (white arrows) due to impaction. § May require additional imaging such as MRI for confirmation of fracture O Pitfall: a rim of osteophytes may form around the femoral head and project over the neck mimicking the sclerotic line of a subcapital fracture O There may be a discontinuity in the normal smooth curve of the superior aspect of the femoral neck as it joins the head O White line of increased density of impacted bone may be seen at base of femoral head O Most common intracapsular fracture of the hip O The more displaced the fragments are, the higher the rate of complications
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |