Orthopaedic Quiz 1

The following is a hip x-ray of a 90yo male who presents to the ED.

Frontal Case Source
Lateral

Lateral

Question 1
What is the salient finding?

Hover over the icon for the answer:
Fractured right neck of femur

Question 2
According to the garden classification, what type/stage is shown in the above images?

Answer:
Garden Type III: complete fracture, incompletely displaced. For more info: https://radiopaedia.org/cases/garden-classification-of-hip-fractures-diagram?lang=gb

Question 3
What would be the treatment for this type of fracture?

Answer:
Type III and IV hip fractures are considered unstable and with high risk of femoral head avascular necrosis, hence are treated with arthoplasty (either hemi- or total hip replacement). Type I and II hip fractures are considered stable and can be treated with internal fixation, preserving the head.

Question 4
What is the difference between a hemi- and a total hip arthroplasty?

Answer:
A total hip arthroplasty consists of replacing both the acetabulum and the femoral head, while hemi-arthroplasty generally only replaces the femoral head.

Question 5
Name 3 complications of arthroplasty.

Answer:
Infection, haematoma, non-union or malunion, implant failure, periprosthetic fracture, loosening or dislocation