Notes for the Module 7 surgical scenario

• Information from the Homerton Orthopaedic Outreach Team (HOOT)
• Day of Admission and Pre-operative Actions
• Post-operative Actions
• Discharge Planning and Possible Complications
• Journal Articles for Scenario

Information from the Homerton Orthopaedic Outreach Team (HOOT)

Given to patients who are having a Dynamic Hip Screw inserted for a fractured neck of femur.

• Admitted to hospital following some kind of trauma eg an accident. Probably admitted via A&E.
• Signs and symptoms following accident would have been
1. Hip pain
2. Inability to put weight through the leg i.e. standing on it
3. Shorten leg
4. Leg rotated/twised inwards
• In A&E an x-ray will be taken showing hip fracture. This hip fracture is called a fractured neck of femur.

Dynamic Hip Screw

The principle being the insertion of the sliding screw through the femoral neck and into the femoral head. The securing plate is subsequently attached to the femur shaft and screws are inserted to compress the two pieces of fractured femur together. (see images)

click on images for larger versions

Journal articles for Module 7 surgical scenario:

• Nursing Times: Falls in older people - taking a multidisciplinary approach
• Psychosocial consequences of falling
• Bionursing - explaining falls in elderly people
• National Service Framework for Older People
• Use of initial risk assessment and recording as the main nursing intervention in identifying risk of falls
• Postoperative variation in neurocognitive and functional status in elderly hip fracture patients
• Functional status in older women following hip fracture
• Principles of post operative patient care
• Total hip replacement
• Anaesthetists Journal
• Diet and menopausal health
• Epidural Analgesia for Post Operative Pain - Part 1
• Epidural Analgesia for Post Operative Pain - Part 2
• Prescription Drugs - Uses and Effects -- Opioids
• The nursing management of pain in older people
• Your fractured neck of femur