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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