Hip Fracture Differential Diagnoses

  • Author: Naveenpal S Bhatti, MD; Chief Editor: Sherwin SW Ho, MD   more...
 
Updated: Jan 13, 2012
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Naveenpal S Bhatti, MD  Attending Physician, Department of Emergency Medicine, Washington Hospital, Fremont, California

Naveenpal S Bhatti, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Janos P Ertl, MD  Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopedic Surgery, Wishard Hospital

Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, and Sierra Sacramento Valley Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Gerard A Malanga, MD  Director of Pain Management, Overlook Hospital; Director of PM&R Sports Medicine Fellowship, Atlantic Health; Clinical Professor, Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Fellow, American College of Sports Medicine

Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Institute of Ultrasound in Medicine, International Spine Intervention Society, and North American Spine Society

Disclosure: Cephalon Honoraria Speaking and teaching; Endo Honoraria Speaking and teaching; Genzyme Honoraria Speaking and teaching; Prostakan Honoraria Speaking and teaching; Pfizer Consulting fee Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Henry T Goitz, MD  Academic Chair and Associate Director, Detroit Medical Center Sports Medicine Institute; Director, Education, Research, and Injury Prevention Center; Co-Director, Orthopaedic Sports Medicine Fellowship

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD  Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and Herodicus Society

Disclosure: Breg, Inc. Consulting fee Consulting; Biomet, Inc. Consulting fee Consulting; GMV, Inc. Arthroscopy Simulator Evaluation and teaching; Smith and Nephew Grant/research funds Fellowship funding; DJ Ortho Grant/research funds Course funding; Athletico Physical Therapy Grant/research funds Course, research funding

References

  1. Jacoby L, Yi-Meng Y, Kocher MS. Hip problems and arthroscopy: adolescent hip as it relates to sports. Clin Sports Med. Apr 2011;30(2):435-51. [Medline].

  2. Kovacevic D, Mariscalco M, Goodwin RC. Injuries about the hip in the adolescent athlete. Sports Med Arthrosc. Mar 2011;19(1):64-74. [Medline].

  3. Blankenbaker DG, De Smet AA. Hip injuries in athletes. Radiol Clin North Am. Nov 2010;48(6):1155-78. [Medline].

  4. Zachazewski JE, Magee DJ, Quillen WS, eds. Athletic Injuries and Rehabilitation. Philadelphia, Pa: WB Saunders; 1996:599-604.

  5. DeLee JC, Drez D, eds. Orthopaedic Sports Medicine: Principles and Practice. Vol 2. Philadelphia, Pa: WB Saunders; 1994:1076-80.

  6. Anderson MK, Hall SJ, Martin M, eds. Sports Injury Management. Baltimore, Md: Lippincott Williams & Wilkins; 2000:412-3.

  7. Shin AY, Gillingham BL. Fatigue fractures of the femoral neck in athletes. J Am Acad Orthop Surg. Nov 1997;5(6):293-302. [Medline].

  8. Sieber FE, Mears S, Lee H, Gottschalk A. Postoperative opioid consumption and its relationship to cognitive function in older adults with hip fracture. J Am Geriatr Soc. Dec 2011;59(12):2256-62. [Medline]. [Full Text].

  9. Canavan PK, ed. Rehabilitation in Sports Medicine: A Comprehensive Guide. Stamford, Conn: Appleton & Lange; 1998:265-6.

  10. Davison BL, Weinstein SL. Hip fractures in children: a long-term follow-up study. J Pediatr Orthop. May-Jun 1992;12(3):355-8. [Medline].

  11. Egol KA, Koval KJ, Kummer F, Frankel VH. Stress fractures of the femoral neck. Clin Orthop Relat Res. Mar 1998;348:72-8. [Medline].

  12. Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty-two intertrochanteric hip fractures. J Bone Joint Surg Am. Mar 1979;61(2):216-21. [Medline]. [Full Text].

  13. Leboff MS, Narweker R, Lacroix A, et al. Homocysteine levels and risk of hip fracture in postmenopausal women. J Clin Endocrinol Metab. Jan 27 2009;epub ahead of print. [Medline].

  14. Shabat S, Nyska M, Eintacht S, et al. Serum leptin level in geriatric patients with hip fractures: possible correlation to biochemical parameters of bone remodeling. Arch Gerontol Geriatr. Mar-Apr 2009;48(2):250-3. [Medline].

  15. Zarin JS, Zurakowski D, Burke DW. Claw plate fixation of the greater trochanter in revision total hip arthroplasty. J Arthroplasty. Feb 2009;24(2):272-80. [Medline].

 
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A subcapital femoral neck fracture. Slight compression of the femoral head onto the femoral neck can be seen. Note the cortical break medially. This fracture could be missed if not closely evaluated.
A view of the contralateral hip for comparison.
Intraoperative x-ray film (fluoroscopic view) of placement of the lag screw.
Addition of a superior derotational screw to maintain alignment and allow compression.
Internal fixation of the subcapital femoral neck fracture with a screw and short side plate with an additional derotational screw above. Final anteroposterior view.
Garden I femoral neck fracture. Note the valgus impaction with compression of the superior femoral head-neck junction.
Lateral view of a Garden I femoral neck fracture. Compression of the head-neck junction inferiorly.
Anteroposterior view of the pelvis with a displaced femoral neck fracture.
Lateral view of a displaced femoral neck fracture.
Displaced femoral neck fracture treated with a conventional, noncemented monopolar hemiarthroplasty.
Lateral view of a unipolar hemiarthroplasty.
An example of a calcar replacement hemiarthroplasty. A low femoral neck fracture extending into the calcar femoralis, not amenable to internal fixation or conventional hemiarthroplasty, requiring a calcar replacement prosthesis.
A lateral x-ray film of a calcar replacement hemiarthroplasty.
 
 
 
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