Neck of Femur Fracture
An old woman falls inside a bathroom as her feet slipped off. Her X-ray is shown as below.
https://kwaktalk.org/ortho/2020/12/27/hip-fractures
What should we know about her ?
When did it happen
Other injuries
Closed or Open fracture
Past Medical History- any medications is she taking , drug allergies, any other co-illnesses including mental health
Initial Management
Analgesia
Plain radiographs
Admission
Routine blood investigations , ECG
Rehydration
Plan for surgery within 48 hours unless a medical condition does not allow.
Initial counselling and consenting
Pre-operative preparation - fitness arrange blood
Propose THR-functionally better
lower reoperation rate
(Cemented cup and stem ,head 32 mm ) , approach - hardinge, orthogeriatrician
How to manage the same case in a 40 years old with neck of femur fracture ?
conserve femoral head by reducing fracture under direct visualization and fixing with screws.
Do you operate the case at night ?
No, operate next morning.
Evident that rapid surgery does not affect outcome but accurate reduction.
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