Radiology 2B Week 6

What are the types of intracapsular proximal femoral fractures?

Subcapital

midcervical

basocervical

What are the types of extra capsular proximal femoral fractures

Intertrochnteric

Trochanteric

Subtrochanteric

What is the most common proximal femoral fracture?

Subcapital

T or F: intracapsular proximal femoral fractures are at higher risk of AVN

True

T or F: Proximal femoral fractures are common in young and middle aged patients

False

What demographic is most affected by proximal femoral fractures?

Old female (2x) patients with osteoporosis

What conditions can predispose someone to proximal femoral fractures?

Osteoporosis*

paget's disease

fibrous dysplasia

benign/malignant bone tumors

osteomalacia

radiation-induced osteonecrosis

What is the female:male ratio for intracapsular proximal femoral fractures?

5:1

How quickly do elderly patients who fracture the proximal femur typically die?

Within 6 months (secondary to cardiac and pulmonary complications)

What % of intracapsualr hip fractures come with AVN?

30%

What % of intracapsular hip fractures come with non-union?

25%

What are the least common forms of intracapsular hip fracture?

basocervical and midcervical

What is the classification system for sub capital femoral neck fractures?

Garden classification system

What are the mechanisms of subcapital femoral fracture?

Impaction or displacement

What is a Garden stage 1?

Impaction of the lateral cortex at the head-neck junction without angulation

What is a garden stage 2?

Impaction with no displacement across the width of the entire neck

What is a garden stage 3?

Complete fracture with partial displacement with surfaces still in apposition

What is a garden stage 4?

Complete fracture with full displacement without apposition

What is indicated by a basicervical fracture?

Pathological fracture due to metastasis

What is indicated by an avulsion. fracture of the greater or lesser trochanter?

Pathology (malignancy)

What type of fracture is intertrochanteric fracture typically?

Comminuted

Where does subtrochanteric fracture occur?

2 inches below the lesser trochanter

What diseases are indicated by subtrochanteric fracture?

Pagets

Metastasis

What drug is associated with subtrochanteric fracture?

Bisphosphanates (Fosamax)

(causes decreased osteoclastic activity)

T or F: Mid-shaft fracture of the femur is common

False (uncommon)

What demographic is greater trochanter avulsion most common in?

Elderly (due to fall)

What imaging modalities are useful for proximal femoral fracture diagnosis?

CT

MRI

Isotopic bone scan