Hip fractures

46 Hip fractures



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Fig. 46.1A There is a sclerotic line traversing the left hip, which represents an intertrochanteric fracture.



Background


This is an important fracture in the ward scenario, often suffered by osteoporotic patients who fall out of bed, and prompt diagnosis is essential. It may also be encountered by on-call junior doctors who may be asked to review the patient following a fall. They may be unfamiliar with how to investigate and refer such a patient. This chapter is intended to help the junior doctor make this diagnosis and to make an appropriate referral.


Patients presenting with hip fractures may also present to A&E or orthopaedics.


Fractures are usually radiolucent (dark on the radiograph) lines traversing bone. Also look for a breach of the cortex, and discontinuity of linear bone trabeculae. If a fracture is impacted look for a sclerotic (white on the radiograph) line traversing the bone – this does not intuitively look like a fracture but in the correct clinical setting should be correctly interpreted as such.


Always get two views if you can (in this case an AP pelvis and lateral hip). A fracture may be completely invisible on one view and obvious on the other.

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Aug 20, 2016 | Posted by in ULTRASONOGRAPHY | Comments Off on Hip fractures

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