Femur fracture: Difference between revisions
| Line 14: | Line 14: | ||
==Management== | ==Management== | ||
*Most | *Most fractures, including all displaced, are treated with ORIF | ||
**Exception is isolated trochanteric | **Exception is isolated trochanteric fracture often does not require surgery | ||
* | **See individual pages for further discussion | ||
*Type and cross/screen for pts at higher risk of hemorrhage: | *Type and cross/screen for pts at higher risk of hemorrhage: | ||
**Age > 75 yrs | **Age > 75 yrs | ||
Revision as of 21:54, 8 June 2015
Background
Femur Fracture Types
Proximal
- Intracapsular
- Extracapsular
Shaft
- Mid-shaft femur fracture (all subtrochanteric)
Clinical Features
Differential Diagnosis
Hip pain
Acute Trauma
- Femur fracture
- Proximal
- Intracapsular
- Extracapsular
- Shaft
- Mid-shaft femur fracture (all subtrochanteric)
- Proximal
- Hip dislocation
- Pelvic fractures
Chronic/Atraumatic
- Hip bursitis
- Psoas abscess
- Piriformis syndrome
- Meralgia paresthetica
- Septic arthritis
- Obturator nerve entrapment
- Avascular necrosis of hip
Diagnosis
- Imaging
- Consider AP pelvis in addition to AP/lateral views to compare contralateral side
- Consider MRI if strong clinical suspicion but negative x-ray
Management
- Most fractures, including all displaced, are treated with ORIF
- Exception is isolated trochanteric fracture often does not require surgery
- See individual pages for further discussion
- 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]
See Also
References
- ↑ Lawrence, VA, et al. Medical complications and outcomes after hip fracture repair. Arch Intern Med. 2002; 162(18):2053-7.