Book contents
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Chapter 9
- Section I Extracapsular fractures of the hip
- Section II Intracapsular fractures of the hip
- Chapter 10
- Chapter 11
- Chapter 12
- Chapter 13
- Chapter 14
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Section II - Intracapsular fractures of the hip
from Chapter 9
Published online by Cambridge University Press: 05 February 2015
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Chapter 9
- Section I Extracapsular fractures of the hip
- Section II Intracapsular fractures of the hip
- Chapter 10
- Chapter 11
- Chapter 12
- Chapter 13
- Chapter 14
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Summary
CANNULATED SCREW FIXATION
Indications
Undisplaced fractures of neck of femur (Garden Grade I, II).
Displaced fractures in patients with adequate bone density and no severe chronic illness (rheumatoid arthritis, renal failure).
Active individuals up to mid 70s.
Pre-operative planning
Clinical assessment
Groin pain localized in the affected hip site – radiation of pain to the knee.
Limb is shortened and externally rotated.
Assess and document neurovascular status of the leg.
In young patients carefulexaminationforotherinjuries must be made, as they are a result of high-energy trauma.
A complete medical examination in elderly patients.
Radiological assessment
Anteroposterior radiograph and a lateral view of the affected hip (Fig. 9.16a,b).
Evaluate head retroversion and posterior comminution.
Assess primary and secondary compression and tension trabeculae on radiographs.
CT or bone scans when physical signs are lacking.
Timing of surgery
The outcome is improved if the surgery is performed within 8 hours.
For young patients it is a true orthopaedic emergency.
Operative treatment
Anaesthesia
Regional (spinal/epidural)and/orgeneral anaesthesia.
At induction, administer prophylactic antibiotic as per local hospital protocol.
Table and equipment
Use a 7.0 or 7.3 cannulated screw set – ensure the availability of the complete set of implants.
A radiolucent table or a fracture table with the appropriate traction devices.
An image intensifier.
- Type
- Chapter
- Information
- Practical Procedures in Orthopaedic Trauma Surgery , pp. 158 - 167Publisher: Cambridge University PressPrint publication year: 2006