Diferencia entre revisiones de «Proximal femur fracture»

Revisión del 21:48 8 jun 2015

Imaging
- Consider AP pelvis in addition to AP/lateral views to compare contralateral side
- Consider MRI if strong clinical suspicion but negative x-ray
Most fx, including all displaced fx, are treated with ORIF
- Exception is isolated trochanteric fx often does not require surgery
Skeletal traction is not beneficial
Type and cross/screen for pts at higher risk of hemorrhage:
- Age > 75 yrs
- Initial Hb < 12
- Peritrochanteric fx
Despite good care, 30-day all cause mortality is 22% and grows to 36% at one year^[1]

Location of femur fractures

Acute Trauma

Chronic/Atraumatic

↑ Lawrence, VA, et al. Medical complications and outcomes after hip fracture repair. Arch Intern Med. 2002; 162(18):2053-7.

Authors:

@@ Línea 22: / Línea 22: @@
 ==Intracapsular==
 ==Extracapsular==
-===Trochanteric===
-*'''Greater Trochanter'''
-**Via direct trauma (older pts) or avulsion injury (adolescents)
-** Hip pain that increases with abduction; tenderness over greater trochanter
-*'''Lesser Trochanter'''
-**Via avulsion due to forceful contraction of iliopsoas (adolescents) or pathologic bone
-**Pts are usually ambulatory; c/o pain in groin worse w/ flexion
-*Treatment for both types:
-**NWB with ortho f/u in 1-2wk
 ==See Also==
 *[[Fractures (Main)]]