Disorders of the hip

Question 1

osteoarthritis

Answer 1

Reduced joint space
 Subchondral sclerosis
 Bone cysts
 Osteophytes

Question 2

fracture of femoral neck

Answer 2

 Intracapsular
 Extracapsular (which are further divided into intertrochanteric and
subtrochanteric)

Question 3

intracapsualr fractures are likely to disrupt …

Answer 3

the ascending cervical branch of the MFCA

Question 4

Extracapsular fracture are not as bad because

Answer 4

the retincular arterial supply to the femoral head is likely to remian intact

Question 5

intracapsualar fracture can lead it

Answer 5

avascular necrosis

Question 6

why is a hip shortened,abducted and externally rotated in a displacement

Answer 6

short lateral rotators PGOGQ contract and laterally roates femoral shaft
strong abductors (glut medius and minamus) of the femur distal to the fractures it rotate the greater trochanter
shortening of the limb as the strong muscles of the thing pull the distal fragment of the femur upwards (rectus femoris,adductor magnus and hamstrings

Question 7

what percentage of hip dislocations are posterior

Answer 7

90%

Question 8

common cause for posterior hip dislocation

Answer 8

impact on dashboard during road traffic accident

Question 9

how does a posterior hip dislocation present

Answer 9

head of femur pulled upwards by strong extensors (glut max and glut min)
adductors of hip cause limb shortening
the anterior fibers of the glut min and med pull on the posteriorly displaced greater trochanter and cause the femur to rotate internally

Question 10

anterior dislocation

Answer 10

external rotation
abducted
slight flexion

Question 11

central dislocations

Answer 11

head of the femur is driven into the pelvis through the acetabulum. it is always a fracture-dislocation.
the femoral head is palpable on rectal examination and there is a high risk of intreapelvic haemorrhage due to disruption of the pelvic venous plexuses