clinical anatomy of proximal femur
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Clinical Anatomy of Proximal Femur
Dr. Khushwant Singh Rathore Department Of
OrthopedicsAll India Institute Of Medical
Sciences, Jodhpur
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What is intra-capsular neck femur fracture?
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What is extra-capsular intertrochanteric femur fracture?
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What is sub-trochanteric fracture?
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Why they behave differently?Intra-capsular FractureNon-unionOsteonecrosis
Extra-capsular fractureMal-unionshortening
Sub-trochanteric fractureNonunionVarus deformity
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Lessons from Anatomy
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Why neck femur fracture goes into osteonecrosis?
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Direct disruption of the intra-capsular arteries
End arterial blood supply
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Intra-capsular Tamponade Ischemia & Nonunion
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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
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Displacing forces in intertrochanteric fractures
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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).
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Clinical application of relevant anatomy