Posted: Dec 23 2021 #(C101904)

Pertrochanteric Femur Fracture in 30M

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HPI

A 30 year old male who presents to the trauma bay after an MVC. Patient states he was the driver when he was in a head on collision. States he was wearing a seat belt. Admits to back and left hip pain. Denies numbness or tingling to Left leg. Admits to smoking a pack a day. Denies previous trauma to LLE.

PMH

Poly-substance abuse

LLE: Sensation intact to light touch grossly. DP and PT pulses palpable. Capillary refill time brisk. Motor intact to EHL, FHL, TA, GS. Pain with log rolling of hip. No open wounds or gross deformities, but there is a superficial abrasion to the left knee, no concern from arthrotomy. TTP to left femur. Compartments are soft to palpation

Poll

1 of 7

In addition to plain film femur radiographs, would you obtain any additional imaging to guide treatment?

1 No - current radiographs are sufficient

2 Yes - additional radiographic views including traction views (XR)

3 Yes - CT scan of the hip/femur (CT)

4 Yes - MRI scan of the hip/femur (MRI)

5 Yes - XR + CT

6 Yes - XR + MRI

7 Yes - CT + MRI

8 Yes - XR + CT + MRI

9 Outside my area of expertise - best if I don't vote

Other

Submit

P: 141813

Would you use a classification system to guide your treatment of the femur fracture?

1 No - a classification system does not help me determine treatment

2 Yes - Russel-Taylor Classification

3 Yes - AO/OTA Classification

4 Yes - Other

5 Outside my area of expertise - best if I don't vote

Other

Submit

P: 141814

How would you manage this patient?

1 Nonoperative - Skeletal traction until union

2 Operative

3 Outside my area of expertise - best if I don't vote

Other

Submit

P: 141815

If you choose Operative management, would you temporize this patient prior to definitive fixation?

1 I would not choose Operative management

2 No - I would operate acutely

3 Yes - temporize short-term with Buck's external traction

4 Yes - temporize short-term with Skeletal traction

5 Yes - temporize short term with external fixation

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 141816

If you choose Operative management and choose to temporize with Skeletal Traction, what type would you use?

1 I would not temporize with Skeletal Traction

2 Distal Femoral Traction Pin

3 Proximal Tibial Traction Pin

4 Calcaneal Traction Pin

5 Outside my area of expertise - best if I don't vote

Other

Submit

P: 141817

If you choose Operative management, what definitive fixation would you perform?

1 I would not choose Operative management

2 External fixation

3 Intramedullary nail fixation (IMN)

4 ORIF (plate, screws, wires)

5 IMN + ORIF

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 141818

If you choose Operative management and attained the construct shown below, what would your postoperative weight-bearing protocol be?

1 I would not choose Operative management

2 Non-weight bearing (NWB)

3 Touch-down weight bearing (TDWB)

4 Partial weight bearing (PWB, < 25%)

5 Weight bearing as tolerated (WBAT)

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 141819

Intra-procedure P1

Post-procedure P1

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