Intracapsular
Femoral head and neck, subcapital, or transcervical
Intracapsular femoral head and neck fractures may disrupt blood supply, resulting in avascular necrosis (1).
Extracaps...
Initial patient evaluation should always first evaluate if patient is stable or unstable with initial rapid survey.
Diagnosis is typically made in the ER; first responders are a critical part...
Urgent surgical repair is indicated for nearly all patients; outcomes are best when done within 24 to 48 hours of injury (1)[C].
Wait times >24 hours for surgical repair associated with h...
Radiographs of the hip prior to discharge and every 6 weeks thereafter until healed after fixation procedure; after arthroplasty, follow-up x-ra...
S72.092F Other fracture of head and neck of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
S72.092H Other fracture of head and neck of left ...
Suspect a hip fracture in elderly patients presenting with a shortened, externally rotated leg, even with minimal trauma.
X-rays are usually sufficient to confirm diagnosis.
Treat hip fr...
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Femoral fractures
FIGURE 5-22. A,B: Anteroposterior (AP) and lateral x-rays showing an undisplaced intertrochanteric fracture in a 30-year-old laborer who fell 12 feet onto his hip while at work. He was treated symptomatically with bed rest for 2 days and then was up on crutches and out of the hospital. C,D: AP and lateral x-rays show healing evident at 4 weeks when the patient was able to return to work on a full-time basis. It's questionable whether this would have been likely if he had been treated with ...
FIGURE 5-22. A,B: Anteroposterior (AP) and lateral x-rays showing an undisplaced intertrochanteric fracture in a 30-year-old laborer who ...
FIGURE 23-2. Intertrochanteric fractures: sliding hip screw. Stable fracture. Notice that the posteromedial cortex remains intact.
FIG. 22.32. A Salter-Harris type II fracture of the right distal femoral physis in a 9-year-old boy. Widening of the growth plate is seen medially (large arrow), and a small metaphyseal fragment has been displaced laterally (small arrow). Closed reduction was successful. In an adult, the same mechanism of injury would have resulted in a medial collateral ligament sprain or tear.
FIG. 22.32. A Salter-Harris type II fracture of the right distal femoral physis in a 9-year-old boy. Widening of the growth plate is seen ...
<bold>FIGURE 113.41</bold> (<i>A</i>) Salter-Harris type III epiphyseal fracture of the medial femoral condyle in 14-year-old boy. (<i>B</i>) Anteroposterior radiograph after anatomic open reduction and internal fixation with cannulated lag screws. (<i>C</i>) Postoperative lateral radiograph of type III medial femoral condylar epiphyseal fracture. Note that lag screws avoid the growth plate on both views. Premature closure of the medial portion of d...
<bold>FIGURE 113.41</bold> (<i>A</i>) Salter-Harris type III epiphyseal fracture of the medial femoral condyle in ...
FIGURE 16-3. Anteroposterior radiograph of a 62-year-old patient's distal femur. The patient had pain for 4 weeks before sustaining a nondisplaced fracture through a lesion in her distal lateral femur. Its appearance on the plain radiograph is suggestive of a metastatic lesion. No other lesions were found and a biopsy was done. The lesion proved to be a primary malignant fibrohistiocytoma of bone. She had a limb salvage resection after preoperative chemotherapy.
FIGURE 16-3. Anteroposterior radiograph of a 62-year-old patient's distal femur. The patient had pain for 4 weeks before sustaining a nond...