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John Curtis

Proximal femoral fractures

This video emphasises the importance of understanding the arterial anatomy of the femoral neck and head in determining which fracture is likely to lead to avascular necrosis of the femoral head.

Broadly speaking we can divide proximal femoral fracture patterns into intracapsular and extracapsular.

Both require different surgical management:

  • Intracapsular Generally treated with arthroplasty although if caught early, before AVN has occurred in a younger patient it can be treated with cannulated screw fixation
  • Extracapsular Does not jeopardise the femoral head blood supply and can be treated with a fixation device such as a dynamic hip screw