Pathology: Femoral Neck Fracture & Colles' Fracture

What is the "prevalence" of femoral neck fracture in the United States?

1 in 3 adults over age 65 fall annually therefore the annual incidence of a hip fracture is approx 1.7 million worldwide.

What is the "mortality rate" of femoral neck fracture in the United States?

Associated with high 1 year mortality rates, and surgical delay greater than 4 days increases the 6 month & 1 year mortality risks.

What is the "incidence" of femoral neck fracture in the United States?

By the year 2040, over 650,000 hip fractures will occur annually in older adults. 18-33% of these older hip fracture patients will die within the first year of their fracture.

Radiographically, how is colles' fracture portrayed on a general imaging study?

Colles' fracture is "dinner fork" deformity, with the distal fragment angled posteriorly/outward. Lateral image demonstrates this posterior displacement. Smith fracture or Reversed Colles' is a displacement of the distal fragment toward the palmar aspect of the ulna, anterior/inward.

Radiographically, how is femoral neck fracture portrayed on a general imaging study?

Displacement or foreshortening appearance. Intracapsular fracture is where the distal fragment is pulled upwards and rotated laterally. Intertrochanteric fracture is where the fracture line is seen between the greater and the lesser trochanters. Sub-trochanteric fracture is below the lesser trochanter, and posteriorly displaced and mildly impacted with the proximal fracture fragment laterally angulated. Non-displaced fracture looks like a crack, and displaced fracture looks foreshortened in an AP and the head of the femur looks broken off in a lateral.

What is the "etiology" (causes) of colles' fracture?

FOOSH: Falling onto outstretched hands. and Osteoporosis.

What is the "etiology" (causes) of femoral neck fracture?

Fall or from a direct blow to the side of the hip, MVA, significant pediatric fall or abuse, or other medical conditions like osteoporosis, cancer, and stress injuries.

What is the "official" definition of femoral neck fracture?

Femoral neck fracture, or intracapsular fracture, is at the level of the neck and the head of the femur. The intracapsule is a soft-tissue envelope that contains the lubricating and nourishing fluid of the hip joint itself

What is the "prognosis" of colles' fracture?

Good position: cast applied. Poor position: re-alignment of broken fragments with closed reduction of wrist. The vast majority of Colles' fractures can be treated with closed reduction and cast immobilization. Surgical intervention involving pins, plates, screws, or external fixation can also be used to correct the fracture.

What is the "prevalence" of colles' fracture in the United States?

Many distal radius fractures in people older than 60 years of age are caused by a GLF; ground level fall. Women over 65yrs are at highest risk, over 7x more likely than men.as well as children between 6 and 10yrs of age.

What is the "incidence" of colles' fracture in the United States?

Most common type of wrist fracture. Approx 75% of all forearm fractures.

Which classification is colles' fracture? Additive or destructive?

Neither. Osteoporosis is destructive however or a cast can be additive.

Which classification is femoral neck fracture? Additive or destructive?

Neither. Pt could however have osteoporosis or be wearing a cast.

What is the "morbidity rate" of femoral neck fracture in the United States?

Only 1 in 4 patients with hip fractures recover completely. Cast is applied to entire leg as well as post-op recovery and regular imaging to monitor healing.

What is the "prognosis" of femoral neck fracture?

Only 1 in 4 patients with hip fractures recover completely. Nonsurgical treatment can apply to those too ill or who were already unable to walk prior, cast may be option if not severe enough. Most common is surgical intervention. Intracapsular hip fractures: percutaneous pinning with individual screws, or large screw slid within barrel of a plate. Sub-trochanteric level fractures: screws if still intact, of long intramedullary nail with large lag screw.

What is the "morbidity rate" of colles' fracture in the United States?

Patients are casted, and may have closed or open reduction. Daily activity is not greatly affected and is temporary.

What is the "official" definition of colles' fracture?

Transverse fracture throughout the distal portion (distal inch of) the radius. The distal fragment is usually angled posteriorly. Usually is accompanied by an avulsion fracture of the ulnar process. The external contour in Colles' fracture display a "dinner fork" deformity.

Under which "causative agent" can femoral neck fracture be classified?

Trauma, fall or direct blow to the side of the hip, MVA, abuse, osteoporosis, cancer, stress injuries.

Under which "causative agent" can colles' fracture be classified?

Trauma: FOOSH, or Pathologic: osteoporosis being destructive taking away from bone strength.

What is the "mortality rate" of colles' fracture in the United States?

Wrist fractures themselves dont result in death, however other medical issues may.