proximal femur fracture a presentation to my fellow medical

proximal femur fracture

1. NECK OF FEMUR FRACTURE UNILUS MUJUKU KAIZA MODERATOR; DR MHONE 19.00

2. INTRODUCTION The femur is the largest and strongest bone in the body. Due to its strength it requires a significant force to break it. However, certain medical conditions that weaken the bone make it more vulnerable to fracture, so called pathological fractures For example: osteoporosis; malignancy;  infection Femoral Neck Fractures: one of the most frequent fractures presenting to the emergency department and orthopedic trauma.usually in elderly patients

3. BASIC ANATOMY OF THE FEMUR The femur or thigh bone is the body's longest and strongest bone, extending from the hip to the knee. It has three main parts: the proximal end (head, neck, greater/lesser trochanters) the shaft and the distal end (condyles, epicondyles, intercondylar fossa). The femur articulates with the pelvis at the hip joint and with the tibia and patella at the knee joint, providing support for the body and enabling movement.   Femoral head: articulates with acetabulum Femoral neck: connects head to shaft Greater trochanter: lateral prominence for muscle attachment Lesser trochanter: posteromedial prominence Blood supply: medial & lateral circumflex femoral arteries, retinacular vessels Other vessels include inferior gluteal artery and the artery of ligamentum teres

4. RISK FACTORS Female > Male Elderly above 60 years History of   fall from standing height May also occur in younger patients from  high-energy trauma Low estrogen levels Metabolic diseases e.g pagets disease and osteoporosis Malnutrition Smoking Previous proximal femur fractures

5. M echanism of injury Low-energy fall  (e.g., tripping at home) in the elderly, there is direct fall on the greater trochanter High-energy trauma  (e.g., car accident) in younger people C linical presentation Hip /groin pain Inability to weight bear Shortened and externally rotated leg Swelling/bruising around the hip

6. INVESTIGATIONS Investigation Purpose X-ray (AP + Lateral) First-line for fracture detection MRI Detect occult fractures CT Alternative to MRI FBC, U&E, CRP Pre-op & general health status Group & Save Prepare for possible blood transfusion Bone profile, Vit D Assess bone health DEXA scan (later) Osteoporosis work-up ECG, CXR Pre-surgical assessment

7. lool shentons line Sss

8. CLASSIFICATION Consists of; INTRACAPSULAR Gardens ,based on degree of displacement A natomical ,site of fracture line P auwels , angle of fracture from the horizontal 2. EXTRACAPSULAR I ntratrochantic (boyd griffin)

9. ANATOMICAL CLASSIFICATION

10. EXTRACAPSULAR

11. MANAGEMENT Resuscitate the patient,remember to treat the patient first not the fracture .

12. COMPLICATIONS Avascular necrosis (AVN) Non-union Deep vein thrombosis (DVT) Pulmonary/fat embolism (PE) Pressure sores Post-op infection

13. Kaciba buyo Ma