Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: •...

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Proximal Femur Fracture

Transcript of Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: •...

Page 1: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

Proximal Femur Fracture

Page 2: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

JT

•  56yoMfalldownstairs• PMH:

•  Alcoholusedisorderwithhistoryofwithdrawals• PSH:

•  RecentTKArequiringacuteI&DforMRSAinfection

•  SH:•  Livesindependently•  4-6drinksperday•  ½packperweek

Page 3: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

• PE:•  LLEshortenedandexternallyrotated•  NVI

Page 4: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring
Page 5: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring
Page 6: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring
Page 7: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

Intraop-Lateral on fracture table

Page 8: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

Immediate Post-op

Page 9: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

• MadeTTWBLLE• Unevenful2-weekfollow-up• Cameto6weekfollow-upwithoutanycrutches

Page 10: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

6-Week Follow-Up

Page 11: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

• OfferedRevisionbutpatientrefused• MadestrictNWBbutreturnedtoclinicatsubsequentfollow-upswithoutcrutches

Page 12: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

9Weeks 12Weeks 16Weeks

Page 13: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

• Painwasincreasingandpatientnotinterestedinsurgery• OfferedTHA

Page 14: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring
Page 15: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

•  2-weekspost-op,patientfellinbathroomandhadsignificantincreaseinpain

Page 16: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring
Page 17: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

• Closedreduced• ReturnedtotheORonedaylateralforrevision

Page 18: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

Unabletoobtainstableacetabularfixationsoexplantedandgrafted.

Page 19: Proximal Femur Fracture · Proximal Femur Fracture . JT • 56 yo M fall down stairs • PMH: • Alcohol use disorder with history of withdrawals • PSH: • Recent TKA requiring

Reimplanted13monthsafterindexprocedure


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