Femoral bone fracture "neck & shaft fractures"

2. Types of femoral bone fractures Neck fracture Inter-trochanteric Sub-trochanteric # Shaft fractures

3. F. Neck fracture General Facts Causes Treatment Complication

4. F. Neck fracture General Facts Causes Treatment Complication Garden classification incomplete Impacted in valgus complete # with partial D. complete with full displacement

5. F. Neck fracture General Facts Causes Treatment Complication Garden classification Classification According to site of # subcapital Transcervical basicervical

6. F. Neck fracture General Facts Causes Treatment Complication Garden classification subcapital Transcervical basicervical Classification According to site of #

7. F. Neck fracture General Facts Causes Treatment Complication Femoral neck # can be missed in 4 groups Garden classification stress # in Elderly Patients Non-displaced # painless ( silent ) # multiple #s Classification According to site of # X Missing F neck Fractures ?

8. F. Neck fracture General Facts Causes Treatment Complication X-ray Garden classification If normal but clinical suspicion of a hip # remains high Classification According to site of # MRI Bone scan Missing F neck Fractures ? Radiologic investigation

9. F. Neck fracture General Facts Causes Treatment Complication falls into greater trochanter simple falls Elderly [as fall from height or RTA high-energy injuries Young

10. F. Neck fracture General Facts Causes Treatment Complication Elderly Young All patients require surgery if fit for an operation Internal F. with lag multiple 3-4 screws or pins placed in parallel fashion Better to have prosthetic replacement

11. F. Neck fracture General Facts Causes Treatment Complication If young Osteonecrosis with To prevent Displaced # Emergent surgery [close or open reduction + internal Fixation]

12. F. Neck fracture General Facts Causes Treatment Complication Nonunion Osteonecrosis Healing inhibition ↑ with displacement & older ↑ with displacement & intracapsular hematoma by Synovial fluids or Angiogenic-inhibiting factors

13. F. Shaft fracture Causes Treatment Complication

14. F. Shaft fracture Causes Treatment Complication If Elderly Always Suspect pathological fracture until proven otherwise high-energy injuries Young

15. F. Shaft fracture Causes Complication Treatment Traction & bracing External fixation if multiple or severe open injuries , severe Bn loss or adolescents if child + have anesthesia problems + inability to do IF Treatment if with neck # or vascular injury Method of choice Intramedullary nailing as controls rotation & stabilize distal third # Open reduction + plating

16. Treatment Method of choice Intramedullary nailing as controls rotation & stabilize distal third # if with neck # or vascular injury Open reduction + plating if child + have anesthesia problems + inability to do IF Traction & bracing if multiple or severe open injuries , severe Bn loss or adolescents External fixation

17. F. Shaft fracture Causes Complication Treatment Intramedullary nailing as controls rotation & stabilize distal third # Method of choice 1

18. F. Shaft fracture Causes Complication Treatment Open reduction + plating if with neck # or VI 2

19. F. Shaft fracture Causes Complication Treatment Traction & bracing if child + have anesthesia problems + inability to do IF 3

20. F. Shaft fracture Causes Complication Treatment External fixation if multiple or severe open injuries , severe Bn loss or adolescents 4

21. F. Shaft fracture Causes Complication Treatment Vascular injury. Thromboembolism Infection Delayed union & non-union Malunion Joint Stiffness