Upload
doankhanh
View
216
Download
0
Embed Size (px)
Citation preview
Seminar on Management of Seminar on Management of Hip FractureHip Fracture
88thth July 2007July 2007
Dr. Kou Sio-Kei
PYNEH
ClassificationClassification
Simple and easily applicableSimple and easily applicableGuide treatmentGuide treatmentProvide prognosisProvide prognosisPredict complicationPredict complicationFacilitate communicationFacilitate communicationEnable systematic documentation and Enable systematic documentation and researchresearch
FactorsFactorsAnatomyAnatomy
Blood supplyBlood supplyMuscle attachmentMuscle attachmentCapsular attachmentCapsular attachment
Pathological anatomyPathological anatomyBone qualityBone qualityMechanism of injuryMechanism of injury
Pathological Pathological physiologyphysiology
Bone healingBone healing
FactorsFactors
BiomechanicsBiomechanicsFracture stabilityFracture stabilityDeforming forcesDeforming forcesImplant strength and configurationImplant strength and configuration
Follow upFollow upSystematic data collectionSystematic data collectionValidation and modification of the Validation and modification of the classification systemclassification system
Proximal Femoral FractureProximal Femoral Fracture
Fracture neck of Fracture neck of femurfemurIntertrochantericIntertrochanteric fracturefractureSubtrochantericSubtrochanteric fracturefracturePaediatricPaediatric proximal proximal femoral fracturefemoral fracture
Fracture Neck of FemurFracture Neck of Femur
Age groupAge groupMechanism of InjuryMechanism of InjuryAssociated injuriesAssociated injuries
Anatomical locationAnatomical locationFracture angleFracture angleFracture displacementFracture displacement
Anatomical locationAnatomical locationIntraIntra--capsularcapsular
SubcapitalSubcapitalTranscervicalTranscervical
ExtraExtra--capsularcapsularBasal Basal
Fracture angle Fracture angle ( ( PauwelsPauwels ))
Amount of shearing Amount of shearing forceforceRisk of non unionRisk of non unionRisk of Risk of avascularavascularnecrosisnecrosis
ValgusValgus osteotomyosteotomy
Fracture displacement ( Garden )Fracture displacement ( Garden )Grade I incomplete or Grade I incomplete or valgusvalgus impactedimpactedGrade II complete Grade II complete undisplacedundisplacedGrade III complete partially displacedGrade III complete partially displacedGrade IV complete displacedGrade IV complete displaced
EliassonEliasson modificationmodificationUndisplacedUndisplaced ( I & II )( I & II )Displaced ( III & IV )Displaced ( III & IV )
Other ConsiderationsOther ConsiderationsRisk of AVNRisk of AVNSurgical complicationsSurgical complicationsAge Age Associated injuriesAssociated injuriesGeneral medical conditionGeneral medical conditionPreservation or replacement of the femoral head Preservation or replacement of the femoral head
IntertrochantericIntertrochanteric FractureFracture
Stable and anatomical reductionStable and anatomical reductionSecondary loss of the reduction after internal Secondary loss of the reduction after internal fixationfixation
Boyd and GriffinBoyd and GriffinEvansEvansKyleKyle’’ssAnatomicalAnatomical
SubtrochantericSubtrochanteric FractureFracture
Risk of Risk of malunionmalunion, , malrotationmalrotation, delayed union and , delayed union and non unionnon union
Cortical bone healingCortical bone healingMechanical stressMechanical stress
Fielding and Fielding and MagliatoMagliatoSeinsheimerSeinsheimer
PaediatricPaediatric Proximal Femoral Proximal Femoral FractureFracture
Presence of growth Presence of growth centerscentersVascular anatomyVascular anatomyVery high risk of Very high risk of avascularavascular necrosisnecrosis
The AO classificationThe AO classification
ClassificationClassification
Simple and easily applicableSimple and easily applicableGuide treatmentGuide treatmentProvide prognosisProvide prognosisPredict complicationPredict complicationFacilitate communicationFacilitate communicationEnable systematic documentation and Enable systematic documentation and researchresearch
Thank youThank you