Checklist for Operative Rx of Intertroch Frx


- See: Anesthesia Considerations and Timing

- PreOp Management:
    - Etiology of Fracture:
         - arrhythmia: consider continuous monitoring
         - hypoxia
         - osteoporosis
         - pathologic hip fractures
         - seizure
         - stroke
    - Functional Status:
         - ambulation status
         - medications:
         - medical conditions
    - Positioning:
         - pt is most comfortable w/ pillow under knee & hip mod. flexed, which relaxes capsule & reduces pressure on & pain in the hip;
         - buck's traction
    - Exam:
         - r/o dental, GI, & GU;
         - decubit
         - r/o previous hip surgery
         - limb is markedly shortened w/ upto 90 deg of external rotation deformity > seen w/ femoral neck fracture;
         - swelling and ecchymosis over the greater trochanter;
         - rarely present as open fractures;
         - attempts to move extremity are painful and are avoided;


- Radiographic Findings:
    - classification
         - stable frx
         - unstable intertrochanteric fractures:
               - reversed obliquity
               - type-IV


- Pre-Operative Planning:
    - anesthesia for hip fractures
    - posting;
    - closed reduction, open reduction, & hemiarthroplasty;
    - template for fracture fragments;
    - sliding screw insertion technique



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, September 18, 2012 3:27 pm