femur

Specific Management

Subcapital Femoral Neck Metastasis

 

Femoral Neck Metastasis MRIMetastasis Proximal Femur

 

Fractures

 

Principle

- do very poorly with fixation

- hemiarthroplasty or THR

- stem should be 2.5 cortical diameters beyond any area of weakness

- THR if acetabulum involved

 

Anatomical Approach to Biopsy

Region specific approaches

 

Theory

- want to traverse one muscle / one compartment

- keep away from NV bundle

- as a rule perform open biopsy through compartment the tumour is in

- this is the compartment that will require surgical removal in wide excision

- direct approach without going through muscle if possible i.e. tibia, distal ulna

 

Lower Limb

 

Thigh

 

Compartment Syndrome

Definition

 

Circulation of tissues within a closed osteofascial space are compromised by increased pressure within that space

 

Most common 

- anterior leg compartment

- flexor compartment forearm

- deep posterior leg compartment

 

Aetiology

 

Prerequisite is volume restricting envelope 

- fascia & skin

- POP

- dressings

 

1.  Increased contents

 

Bleeding / edema 

- fracture