Junior call case 15
Displaced impacted subcapitular fracture left femoral neckX-ray sensitivity for the detection of hip fractures is both “operator-dependent” as well as technically limited (due to associated osteopenia, projection, etc.).
• If there is a high clinical suspicion of fracture and the x-ray is “negative”, cross-sectional imaging should be obtained.
It is important to describe the location of the fracture, in particular femoral neck vs. intertrochanteric, as management is different:
o Femoral neck fracture
- Intra-capsular
- Disrupts blood supply = ↑ risk of AVN + NON-UNION
- TX = requires open surgery / total hip arthroplasty (if minimally displaced, may only need screws/pins)
o Intertrochanteric fracture
- Extra-capsular
- Minimal risk of AVN
- TX = dynamic screw
Accession: CL0742
Study description: DX PELVIS 1V
