6. Pelvis and hips

Question 1

what are avulsion fractures commonly caused by

Answer 1

muscle contraction and chronic stress

Question 2

what are the 3 common sites of avulsion fractures in the pelvis

Answer 2

anterior superior iliac spine
anterior inferior iliac spine
ischial tuberosity

Question 3

what is the muscle associated with anterior superior iliac spine avulsion

Answer 3

sartorius

Question 4

what is the muscle associated with anterior inferior iliac spine avulsion

Answer 4

rectus femoris

Question 5

what is the muscle associated with ischial tuberosity avulsion

Answer 5

adductor magnus

Question 6

what shape is the male vs female pelvic inlet

Answer 6

male is V shaped

Question 7

what are stable pelvic fractures

Answer 7

portions of pelvis are still attached doesnt mean whole pelvis is unstable

Question 8

where are the common areas of stable pelvic fractures

Answer 8

through superior inferior rami and sacral alae

Question 9

what are unstable pelvic fractures

Answer 9

involves rings such as pelvic inlet and obturator foramen

one portion of the pelvis to become loose and havent got contact point

Question 10

what are AP compression injuries due to - 3 things

Answer 10

head on motor vehicle collisions
motorcycle accident
pedestrian is struck by vehicle

Question 11

what direction is the force in a AP compression injury

Answer 11

AP or PA

Question 12

what are lateral compression injuries due to - 2 things

Answer 12

side impact motor vehicle collisions

pedestrians struck from the side

Question 13

what are vertical shear injuries due to - 2 things

Answer 13

fall from height

motor vehicle collisions

Question 14

what is the vector of force in vertical shear injuries

Answer 14

caudocranial

Question 15

what do vertical shear injuries normally involve in terms of the pelvis anatomy

Answer 15

usually involving 1 hemipelvis

Question 16

what does AP compression injuries involve in terms of pelvic anatomy

Answer 16

diastasis of pubic symphysis

Question 17

what does lateral compression injuries involve in terms of pelvic anatomy

2 fractures

Answer 17

fracture of obturator foramen and sacrum

Question 18

what does vertical shear injuries involve in terms of pelvic anatomy

2 fractures and one other injury

Answer 18

obturator foramen fracture and sacrum/SIJ fracture and one hemipelvis pushed out of line

Question 19

what are characteristic features of an AP compression injury

2 things

Answer 19

symphyseal and SIJ diastasis

Question 20

what are characteristic features of a lateral compression injury

2 things

Answer 20

sacral buckle fracture and overlapping pubic rami fractures

Question 21

what are characteristic features of a vertical shear injury

2 things

Answer 21

hemipelvis displaced in cranial direction

associated SIJ diastasis

Question 22

what needs to be assessed for sacral fractures

Answer 22

arcuate lines, if crinkled indicates fracture

Question 23

is xray or CT better for sacral fractures

Answer 23

CT

Question 24

if you see too much of lesser trochanter is the femur head int or ext rotated and what is the foot like

Answer 24

external rotation

foot is too far out

Question 25

if a fracture of the femur head is intracapsular/through neck of femur what will it do to the blood supply

Answer 25

will cut off blood supply leading to avascular necrosis of femur head

Question 26

what are the 5 types of femur head fractures

Answer 26

``` subcapital transcervical bse of neck/basicervical intertrochanteric subtrochanteric ```

Question 27

what is a femoral neck fracture in terms of the capsule

Answer 27

intra capsular - within hip joint and beneath the fibrous joint capsule

Question 28

what is a intertrochanteric fracture in terms of the capsule

Answer 28

extra capsule - outside of hip joints fibrous capsule

Question 29

where are subtrochanteric fractures

Answer 29

located distal to the lesser trochanter in proximal part of femur shaft

Question 30

what is the subtrochanteric fractures stability in relation to the other 2 types of hip fractures

Answer 30

less stable as they move

Question 31

what is the shenton line and where is it

Answer 31

along neck of femur and roof of obturator foramen if displaced, neck of femur fracture is present

Question 32

what are the dislocations for hips

Answer 32

posterior | anterior central

Question 33

most hip dislocations are in what direction

Answer 33

posterior

Question 34

what is a common associated finding of hip dislocations

Answer 34

acetabulum

Question 35

the lower limb is commonly orientated what way in hip dislocations

Answer 35

internally rotated, adducted and flexed

Question 36

what does posterior dislocations look like on film

Answer 36

appears are having risen up

Question 37

what is the treatment for hip fractures

Answer 37

post reduction

Question 38

what can happen with posterior hip dislocation in terms of the joint

Answer 38

intra-articular fragments can occur

Question 39

what is the mechanism for anterior hip dislocations

Answer 39

MVA or blow to back while squatting forced abduction