$femoral neck vs intertrochanteric fracture$

Posteromedial corticocancellous trabecular column (calcar).Īnterolateral corticocancellous trabecular column. Vertical trabecular column corresponding to the calcar and the horizontal trabecular column arising from the anterior wall to the neck and femoral head as described by Hammer. Note the cut-away of thin (2–4 mm) cortical wall and trabecular internal structures. Vascular foramina enter the posterior neck from the 1 to 9 o’clock positions as branches of the medial circumflex femoral artery. Note the metaphyseal fracture zone and components greater trochanter (GT), lesser trochanter (LT), femoral head and neck (FH), subtrochanteric (ST) shaft. Loss of these arcades predisposes to weakening of the hip structure and propensity to fracture (▶ Fig.

$femoral neck vs intertrochanteric fracture$

The two primary trabecular arcade patterns are dense cancellous bone columns that are formed in response to load transfer from standing and sitting.

$femoral neck vs intertrochanteric fracture$

It is composed of a cortical shell adjacent to and covering an internal trabecular cancellous bone network extending from the head through the femoral neck and terminating in the thickened cortical tubular diaphysis below the lesser trochanter (▶ Fig. Subtrochanteric diaphysis (origin of the intramedullary canal). Pertrochanteric metaphyseal primary fracture line.įemoral head and intracapsular neck fragment. The pertrochanteric–subtrochanteric hip originates from the extracapsular femoral neck extending to the proximal one-third of the femoral diaphysis (~5 cm below the lesser trochanter).Ĭomponents of the hip fracture include the following: A difference in sound or pitch between extremities implies a fracture defect between femur and pelvis resulting in impedance of percussive conduction.ĭo not manipulate the extremity until after evaluation of radiographic examination if the extremity is deformed or auscultation test is positive.

$femoral neck vs intertrochanteric fracture$

Percuss both patellae with the stethoscope bell overlying the symphysis pubis. Physical findings may consist of lower extremity deformity with external rotation and shortening, bruising of the lateral proximal thigh or buttocks, and the inability to lift the affected leg off the stretcher with pain.Īuscultation test is a helpful screening tool. Past history may include an osteoporosis diagnosis, previous contralateral hip or other fragility fracture, and prior bisphosphonate therapy. Mechanism of injury-ground level fall (elderly patients) or high-energy trauma (typically younger patients). The presenting complaint is pain about the groin or hip with possible radiation to the knee and inability to ambulate or bear weight on the affected leg.

$femoral neck vs intertrochanteric fracture$

Femoral neck vs intertrochanteric fracture