Dissector of thigh              Femur

Causes Diagnosis Management
 
  • History: A fall often in an elderly woman.
  • Inspection: Real and apparent shortening of affected limb in unimpacted fracture and limping in impacted one.
  • Examination: Tap on knee on the axis of femoral shaft elicites pain in impacted one. In the unimpacted the leg is externallly rotated and adducted
  • Xray:
  • Reduction as quickly as possible to reduce the chances of head of femur losing its blood supply which comes mainly from ligament of head of femur.
  • If firmly impacted then continue to ambulate with use of sticks.
  • Use anti-rotation bar to shoe to be worn in bed if fully impacted.
  • Unmipacted fractures should be treated by internal fixation or excision of the head with replacement with prosthesis after surgical exposure.
  • Complication like avascular necrosis of head of femur should be treated with hip joint arthroplasty.

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I                                
Internal rotation & adduction

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