股骨转子间骨折 PPT
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cluttered floors
Anatomy and Biomechanical
Calcar femorale
Internal scaffolding system of trabecular bone
The Singh grading system
Muscular Anatomy
The iliopsoas The major abductors The adductors The external rotators The hip extensors
most common in extracapsular hip fracture. 3％ ～4％ in fracture, 35.7％ in hip fracture. The elder people Mortality:15-30% F>M
Mechanisms
The elder population Low-energy falls falls Postural and gait disturbances Decreased visual Hearing acuity Osteoporosis
varus external rotation
Muscular Anatomy
The external rotators （the piriformis, the superior gemellus, the inferior， gemellus, the obturator internus, the obturator externus, and the quadratus femoris)
MeΒιβλιοθήκη Baiduhanisms
The Yonger population High-energy mechanism associated injuries Spine Fibala Pelvis
pathologic fracture
Clinical characteristics
The elder population The poor quality of bone mass Systemic disorders Diabetes Cerebral-vascular disease
Femoral Intertrochanteric Fractures
Reference
Definitaon
From the extracapsular femoral neck to the area just distal to the lesser trochanter.
General Situation
external rotation
Muscular Anatomy
The hip extensors (hamstrings and gluteus maximus)
shorten the extremity
Presentation and Diagnosis
F Pain, swelling, petechia Axial pain unable to weight bear on that leg shortened leg with external rotation DR（AP，cross-table lateral of Hip） CT Technetium 99m bone scanning MRI
Muscular Anatomy
The iliopsoas acts primarily to flex and externally rotate the hip joint
shorten the limb
Muscular Anatomy
The major abductors （the gluteus medius, the gluteus minimus, and the tensor fasciae latae）
（1）The orientation of the faller should lead to an impact at or near the trochanter. （2）the protective responses of the patient （3）local soft tissues around the hip are unable to dissipate energy adequately （4） the bone strength is less than that necessary to withstand the residual energy imparted
Gender: F
Risk Factors
Nutrition: lack of calcium and Vit D in diet, eating disorders (anorexia), high caffeine intake
Smoking Alcohol Medication: steroids, anticonvulsants, diuretics Environmental factors: loose rugs, dim lighting,
shorten the limb varus deformity.
Muscular Anatomy
The adductors (the adductor longus, the adductor brevis, the posterior portion of adductor magnus,and the gracilis)
No-operation Pneumonia Bedsore DVT Urinary infection
Risk Factors
Age: >65 years Co-morbid factors: osteoporosis, endocrine
disorders (hyperthyroidism, hypogondaism), GIT disorders interfering with calcium/ Vit D absorption, neurological disorders (Parkinsons)
Anatomy and Biomechanical
Calcar femorale
Internal scaffolding system of trabecular bone
The Singh grading system
Muscular Anatomy
The iliopsoas The major abductors The adductors The external rotators The hip extensors
most common in extracapsular hip fracture. 3％ ～4％ in fracture, 35.7％ in hip fracture. The elder people Mortality:15-30% F>M
Mechanisms
The elder population Low-energy falls falls Postural and gait disturbances Decreased visual Hearing acuity Osteoporosis
varus external rotation
Muscular Anatomy
The external rotators （the piriformis, the superior gemellus, the inferior， gemellus, the obturator internus, the obturator externus, and the quadratus femoris)
MeΒιβλιοθήκη Baiduhanisms
The Yonger population High-energy mechanism associated injuries Spine Fibala Pelvis
pathologic fracture
Clinical characteristics
The elder population The poor quality of bone mass Systemic disorders Diabetes Cerebral-vascular disease
Femoral Intertrochanteric Fractures
Reference
Definitaon
From the extracapsular femoral neck to the area just distal to the lesser trochanter.
General Situation
external rotation
Muscular Anatomy
The hip extensors (hamstrings and gluteus maximus)
shorten the extremity
Presentation and Diagnosis
F Pain, swelling, petechia Axial pain unable to weight bear on that leg shortened leg with external rotation DR（AP，cross-table lateral of Hip） CT Technetium 99m bone scanning MRI
Muscular Anatomy
The iliopsoas acts primarily to flex and externally rotate the hip joint
shorten the limb
Muscular Anatomy
The major abductors （the gluteus medius, the gluteus minimus, and the tensor fasciae latae）
（1）The orientation of the faller should lead to an impact at or near the trochanter. （2）the protective responses of the patient （3）local soft tissues around the hip are unable to dissipate energy adequately （4） the bone strength is less than that necessary to withstand the residual energy imparted
Gender: F
Risk Factors
Nutrition: lack of calcium and Vit D in diet, eating disorders (anorexia), high caffeine intake
Smoking Alcohol Medication: steroids, anticonvulsants, diuretics Environmental factors: loose rugs, dim lighting,
shorten the limb varus deformity.
Muscular Anatomy
The adductors (the adductor longus, the adductor brevis, the posterior portion of adductor magnus,and the gracilis)
No-operation Pneumonia Bedsore DVT Urinary infection
Risk Factors
Age: >65 years Co-morbid factors: osteoporosis, endocrine
disorders (hyperthyroidism, hypogondaism), GIT disorders interfering with calcium/ Vit D absorption, neurological disorders (Parkinsons)