clinical anatomy of proximal femur
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Transcript of clinical anatomy of proximal femur
Clinical Anatomy of Proximal Femur
Dr. Khushwant Singh Rathore Department Of
OrthopedicsAll India Institute Of Medical
Sciences, Jodhpur
What is intra-capsular neck femur fracture?
What is extra-capsular intertrochanteric femur fracture?
What is sub-trochanteric fracture?
Why they behave differently?Intra-capsular FractureNon-unionOsteonecrosis
Extra-capsular fractureMal-unionshortening
Sub-trochanteric fractureNonunionVarus deformity
Lessons from Anatomy
Why neck femur fracture goes into osteonecrosis?
Direct disruption of the intra-capsular arteries
End arterial blood supply
Intra-capsular Tamponade Ischemia & Nonunion
Problems with intertrochanteric fractures(Extra-capsular#)
Vascularity is not an issue – problem of plenty
Cancellous bone – Union is not an issue
Issue is Mal-union & Coxa vara
Displacing forces in intertrochanteric fractures
Problems with sub-trochanteric fracture?
Deforming muscle forces (arrows) acting on a subtrochanteric femur fracture. Antero-posterior view showing varus deformity caused by strong abductors acting on the proximal segment (A). Lateral view showing flexion caused by iliopsoas (B).
Clinical application of relevant anatomy