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Hip fractures
The document provides an educational overview of hip fractures, specifically focusing on femoral neck fractures, their causes, symptoms, and management strategies. It outlines treatment options such as fixation techniques and hemiarthroplasty, emphasizing postoperative care and rehabilitation exercises. Additionally, it mentions potential complications and the importance of follow-up appointments for recovery.
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Hip fractures
- 2. Dr. A.MOHAN KRISHNA M.S.ORTHO,MCh ORTH(U.K) Consultant Orthopaedic surgeon , Trauma, Arthroscopy, Arthroplasty Surgeon Apollo hospitals, Hyderabad Consultant Orthopedic Surgeon at www.drmohankrishna.com www.healthyjointclub.com www.bonesandjointsclinic.com
- 3. This presentation issolely for educational purpose. The material included in the presentation represents educational material for the patients and not intended for any treatment purpose DISCLAIMER
- 4. HIP FRACTURES BALL-AND-SOCKET JOINT:Ball shaped femoral head and cup shaped acetabulum The upper end of thigh bone is made up of femoral head, neck and trochanter Hip fractures can occur at -Femoral head, -neck -trochanter
- 5. HIP FRACTURES: FEMORAL NECKFRACTURES Fracture adjacent to the femoral head in the neck between the head and the greater trochanter
- 6. FEMORAL NECK FRACTURES: CAUSES Elderly: Common / weak osteoporotic bone Common cause in elderly : - Due to slip and fall on the hip - Direct blow on the hip - Trivial twisting injury to the leg
- 7. FEMORAL NECK FRACTURES:CAUSES Young : -High velocity road traffic accidents -Fall from heights
- 8. FEMORAL NECK FRACTURES: COMPLAINTS -Painin the injured hip -Inability to bear weight - Inability to move the hip -Bruising over hip and groin
- 9. FEMORAL NECK FRACTURES: MANAGEMENT Fall/injuryto hip Emergency/Clinic X –rays & Necessary tests
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- 11. FEMORAL NECK FRACTURES: MANAGEMENT Diabetes/Hypertension Cardiac/Neurological conditions Kidney / liver problems Physician / Diabetologist opinion Cardiologist / neurologist opinion Specialist opinion
- 12. FEMORAL NECK FRACTURES: MANAGEMENT 2DEcho Blood tests Chest X ray/ ECG
- 13. FEMORAL NECK FRACTURES: MANAGEMENT Headof Femur : Precarious blood supply – Injury or fracture damages blood supply Avascular necrosis subsequent arthritis Young individuals Up to age of 50 years Preserve Head by fixing the fracture Elderly : above 50 years / weak osteoporotic bone Replace Head of femur Hemiarthroplasty/ Total Hip replacement.
- 14. FEMORAL NECK FRACTURES:FIXING FRACTURE NECK OF FEMUR SCREW FIXATION: - Under Spinal anaesthesia - Fracture is reduced - Fixed with 2 or 3 screws - Special X ray machine – C-Arm is used - Done through small incision on upper part of thigh
- 15. FIXING FRACTURE NECKOF FEMUR DYNAMIC HIP SCREW FIXATION (DHS) - Under Spinal anaesthesia - Fracture is reduced - Fixed with large screw and side plate assembly - Special X ray machine – C-Arm is used - Done through small incision on upper part of thigh
- 16. FIXING FRACTURE NECKOF FEMUR DAY 1 in the hospital • Moving in and out of bed • Walking with the help of walker without weight on operated leg Day 2 • Plan for discharge • Basic exercises in bed Discharge advice • Revisit after 2 weeks for stitch removal • Not to sit on the ground or cross legged
- 17. POST OPERATIVE FOLLOWUPAFTER FIXING HIP FRACTURES 6 weeks follow up • X-ray to see progress of healing • Partial weight bearing with walker 3 months after surgery • X ray to see the progress of healing • Full weight bearing on the operated leg 3 months to 6 months after surgery • Fracture healing takes 3 to 6months • Follow up every 6 weeks till fracture heals
- 18. FIXING FRACTURE NECKOF FEMUR Implant failure Nonunion Avascular necrosis of head of femur Infection Complications
- 19. FEMORAL NECK FRACTURES: HEMIARTHROPLASTY Elderly: above 50 years / weak osteoporotic bone Replace Head of femur - Hemiarthroplasty - Total Hip replacement. HEMIARTHROPLASTY: Surgery in which ball of the hip joint replaced by metallic ball
- 20. HEMIARTHROPLASTY: Surgery HEMIARTHROPLASTY: -Spinal anaesthesia. -Hip joint is opened and ball is removed. - Thigh bone is prepared to hold the prosthesis with or without the help of cement. - Artificial ball is relocated into the acetabulum of hip joint.
- 21. Day 1 Exercises forankles and toes to prevent blood clots. Full weight bearing walking with walker. You can sit on a chair or take a few steps with a frame Day 2 Removal of bandage and drain from the Hip joint Knee exercises – straightening / bending. Allowed to go to bathroom. Day 3 Walking up and down the stairs Continue the exercises You may be able to go home within 3 to 4 days after the operation HEMIARTHROPLASTY: Postoperative advice
- 22. Stitches / clipsremoved at 12 - 14 days You can shower/ bathe after removal of stitches / clips Return to household work & other day to day activities in 6-8 weeks HEMIARTHROPLASTY: Postoperative advice
- 23. Frequent deep breathing1 Pull yourtoes towards you and point away. 2 Circle your feet in both directions 3 Push knee down Tighten thigh muscles Count to 10 and relax Do it 10 times / hour 4 Place a rolled towel under your knee. Lift your heel to straighten knee. Count to 10 and do 10 times / hour 5 Place a rolled towel under your knee. Push your knee and heel down. Count to 10 and do 10 times / hour 6 HEMIARTHROPLASTY: Exercises
- 24. Sit at theedge of bed / chair. Bend the operated leg and straighten slowly. Repeat 10 times/hour. 7 Note: it is important to do frequent repetitions of all exercises for a short time than spending more time on exercises once or twice a day. Do not force any movements HEMIARTHROPLASTY: Exercises
- 25. Raise and supportyour operated leg on a stool Do walk short distances initially As you get stronger increase the distance of walking HEMIARTHROPLASTY
- 26. HEMIARTHROPLASTY: COMPLICATIONS Infection Deepvein thrombosis(DVT) Neurovascular injuries Dislocation of prosthesis complications
- 27. CONTACT Dr.A.MOHAN KRISHNA M.S.Ortho., MChOrtho(U.K)., Consultant Orthopaedic Surgeon, Apollo Hospitals, Hyderabad. Appointments: Secretary : 09247258989 09441184590 08332936085 www.drmohankrishna.com www.healthyjointclub.com www.bonesandjointsclinic.com Email: [email protected]