Summary: I'm joined by Mo Sarraj (PGY-2) to discuss hip fractures. Learning objectives are (1) accurately classify fractures of the proximal femur, (2) describe treatment options for each fracture type, (3) understand landmark RCTs in hip fracture management, (4) learn high-yield pearls for managing hip fracture patients in residency.

Timestamps:

1:15 - Background (Hip Fractures)

1:30 - Assessment

2:45 - Anatomy

4:05 - Diagnosis

5:45 - Femoral Neck Fracture (FNF) Classifications

6:20 - Pauwel's Classification

7:05 - Garden Classification

7:40 - FNF Treatment

8:30 - Stable FNF Treatment Options

10:15 - Assessing Intraoperative Reduction

11:00 - Cancellous Screw ORIF

14:45 - Sliding Hip Screws

15:00 - FAITH trial

16:05 - Unstable FNF Treatment Options

17:30 - Hemiarthroplasty vs THA

18:20 - HEALTH trial

18:50 - Intertrochanteric Fractures (ITF)

19:30 - ITF Classification

21:35 - ITF Treatments

23:10 - Subtrochanteric Fractures

24:00 - Clinical Scenario & Practical Tips

30:10 - Summary

Resources:

Hip Fracture Management Summary Paper (NEJM, 2017): https://www.nejm.org/doi/10.1056/NEJMcp1611090

HIP ATTACK (Lancet, 2020): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30058-1/fulltext

FAITH (Lancet, 2017: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30066-1/fulltext

HEALTH (NEJM, 2019): https://www.nejm.org/doi/full/10.1056/NEJMoa1906190 

Intertrochanteric Fracture Treatment Biomechanics (IJO, 2015): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443419/ 

OrthoBullets: https://www.orthobullets.com/trauma/1037/femoral-neck-fractures & https://www.orthobullets.com/trauma/1038/intertrochanteric-fractures