clinical anatomy of proximal femur

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Khushwant Rathore

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Healthcare

Clinical Anatomy of Proximal Femur
Dr. Khushwant Singh Rathore
Department Of Orthopedics
All India Institute Of Medical
Sciences, Jodhpur

$What is intra-capsular neck femur fracture?$

$What is extra-capsular intertrochanteric femur fracture?$

$What is sub-trochanteric fracture?$

$Why they behave differently? Intra-capsular Fracture Non-union Osteonecrosis Extra-capsular fracture Mal-union shortening Sub-trochanteric fracture Nonunion Varus deformity$

$Why neck femur fracture goes into osteonecrosis?$

Direct disruption
of the intra-
capsular arteries
End arterial
blood supply

Intra-capsular
Tamponade Ischemia &
Nonunion

$Synovial Fluid Dilution of fracture hematoma Collagenases Angiogenesis inhibitors$

$Problems with intertrochanteric fractures(Extra-capsular#)  Vascularity is not an issue – problem of plenty  Cancellous bone – Union is not an issue  Issue is Mal-union & Coxa vara$

$Displacing forces in intertrochanteric fractures$

$Problems with sub-trochanteric fracture? Deforming muscle forces (arrows) acting on a subtrochanteric femur fracture. Antero- posterior view showing varus deformity caused by strong abductors acting on the proximal segment (A). Lateral view showing flexion caused by iliopsoas (B).$

Clinical application of relevant
anatomy

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