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10 - Section I: Extracapsular fractures of the hip

Published online by Cambridge University Press:  05 February 2014

By
Peter V. Giannoudis  and
Christopher Tzioupis
Edited by
Peter V. Giannoudis  and
Hans-Christoph Pape
Peter V. Giannoudis
Affiliation:
Leeds General Infirmary University Hospital
Christopher Tzioupis
Affiliation:
Leeds General Infirmary University Hospital
Peter V. Giannoudis
Affiliation:
University of Leeds School of Medicine
Hans-Christoph Pape
Affiliation:
University of Aachen Medical Centre
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Summary

Indications

Sliding compression hip screw devices are used to stabilize:

  • Stable intertrochanteric hip fractures (Fig. 10.1.1).

  • Rotationally unstable, comminuted and vertical (Pauwels type 3) intracapsular fractures of neck of femur.

Preoperative planning

Clinical assessment

  • Pain localized in the affected hip side – radiation of pain to the knee.

  • Limb is shortened and externally rotated.

  • Assess and document the neurovascular status of the leg.

  • In young patients careful examination for other injuries must be made, as these fractures are a result of high-energy trauma.

  • A complete medical examination in elderly patients.

Radiological assessment

  • Anteroposterior radiograph and a lateral view of the afected hip to demonstrate the fracture geometry.

  • Anteroposterior radiograph of the pelvis to estimate the contralateral ‘normal’ neck-shat angle.

Preoperative consent

  • Obtain informed consent from the patient, including but not limited to risks, beneits, alternatives, complications and potential outcome.

Operative treatment

  • The World Health Organization (WHO) Surgical Safety Checklist should be used in the operating room.

Type
Chapter
Information
Practical Procedures in Orthopaedic Trauma Surgery , pp. 246 - 259
Publisher: Cambridge University Press
Print publication year: 2014

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