Hip

Question 1

What is a hip fracture?

Answer 1

Fracture of femur above a point 5cm below most distal lesser trochanter

Question 2

How is a hip fracture classified?

Answer 2

-Intracapsular(femoral neck): subcapital, transcervical, basicervical, intertrochanteric, subtrochanteric

Question 3

What is the main blood supply to the femoral head?

Answer 3

• Trochanteric anastomosis from femoral circumflex arteries

- Small contribution from branch of obturator artery

Question 4

What are the risk factors for hip fractures?

Answer 4

• Ageing
• Falls
• Osteoporosis

Question 5

What is the aetiology of low impact hip fractures?

Answer 5

• Osteoporosis
• Osteomalacia
• Bone metastases
• Paget’s disease
• Haematological malignancy

Question 6

What are the clinical features of a hip fracture?

Answer 6

• Fall
• Pain (groin, thigh,knee)
• Difficulty in weight-bearing
• Deformity (shortened limb, external rotation)
• Complications of fall/immobility

Question 7

What tests need to be carried out on a suspected hip fracture?

Answer 7

• FBC: U&E, blood glucose
• Creatine kinase-rhabdomyolysis
• Calcium profile
• Xray & CXR
• ECG

Question 8

What surgical management is available for fractures?

Answer 8

• Intracapsular: replacement hemiarthroplasty

- Extracapsular: dynamic hip screws, cannulated screws

Question 9

What are complications of a hip fracture?

Answer 9

• Cardiac
• UTIs & urinary retention
• Pressure sores
• Pseudo-obstruction
• Malnutrition
• Bronchopneumonia
• Thromboembolism (PE, DVT)
• Wound infections