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Lecture

Top Testing Tips for Intertrochanteric Hip Fracture Management

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Transcript

225 words · 2 min

  1. Hello, this is Bruce Gomberg, director of the Maine Orthopedic Review. Together with my colleague, Doctor Ted Manson of the University of Maryland, we present top testing tips for management of the introchanteric Hip fracture.

  2. Number one, know that there is no difference between cephalomedullary nail and sliding Hip screw constructs in terms of length of Surgery, intraoperative blood loss, transfusions, and radiation exposure, time to union, wound infection, implant cutout, post-op anatomical deformities, mortality, and post-op Pain.

  3. Number 2, historically there have been increased intraoperative and postoperative fractures with cephalomedullary nails, but this may be improved with improved modern designs.

  4. 3.

  5. Know the tip apex distance and why it's important. It's less than 25 millimeters combined on both the AP and lateral views of the Hip and holds for both nails and sliding Hip screws.

  6. Number 4, if there is a subtrochanteric extension of the Fracture on radiographs, use a cephalomedullary nail. If there is no lesser trochanteric involvement, the correct test choice is most likely a sliding Hip screw.

  7. Number 5. Know how to recognize a reverse oblique Fracture pattern. If it's present, Treat it with a cephalomedullary nail. One study showed a 56% failure rate using a sliding Hip screw alone in this situation.

  8. Those are my testing tips. Hope they will help you ace the exam and I'll see you in Maine.

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