Fractures of the femoral neck 股骨颈骨折.pptVIP

* Fractures of the femoral neck Liu Feng Nanjing Medical University Terminology Femur—股骨 Femoral neck—股骨颈 Aseptic necrosis—无菌性坏死 Non-union—不愈合 T ensile trabeculae—张力性骨小梁 Compressive trabeculae压力性骨小梁 Reduction—复位 Periosteum—骨外膜 Total hip replacement—全髋关节置换 Hip prosthesis—髋假体 The Main Features of the Femoral Neck Fracture Especially common in elderly people More frequent in women than men (osteoporosis) The incidence is increasing in young patients (industry injury) The most common complications are non-union and avascular necrosis Have a tremendous impact on health care system and society Fraught with complications, the fracture is among the most troublesome and problematical fractures The mortality (死亡率)after this fracture is as high as 30% Anatomy of the Femoral Neck The normal shaft-neck angle:127 127: valgus deformity 127:varus deformity Anatomy of the Femoral Neck---Anterior tilt angle Anatomy load Why do we discuss the normal anatomy? To ensure the correct reduction and fixation of the fracture Vascular Anatomy The foveal artery: obturator artery The ascending branches from the nutrient artery Only supply small parts of blood to the head The extracapsular arterial ring----the intracapsular ring the main vessels to the head----2/3-3/5 Lateral femoral circumflex artery Medial femoral circumflex artery Profundas femoral artery Mechanism of Injury The first: a fall producing a direct blow over the great trochanter The second : lateral rotation of the extremity Most common in elderly women The injury is minor or trivial In young patients: major trauma resulting in a direct force along the shaft of the femur---industry injury or car accident Classifications: Anatomic Location