Flashcards in Disorders of the Hip/Pelvis Deck (33):
What are the two main types of hip dislocations? what type of accidents do they occur in?
high energy accidents
which of the two types of hip dislocations is more common?
describe posterior hip dislocations:
Hip typically in a flexed position
Leg typically shortened, adducted, internally rotated
Describe anterior dislocations:
Hip extension and external rotation
Hip is flexed, abducted, and externally rotated
What is the treatment for a hip dislocation?
Closed Reduction if no Fx
Increased risk of AVN of the femoral head
Sciatic Nerve injury 10-20% of cases
What is congenital dysplasia of the hip
Shallow development of acetabulum
what are you at risk for with CDH? what puts you at risk for CDH?
Increased risk of dislocations
Increased risk of Osteoarthritis (OA)
Breech Birth or Breech Presentation
Associate with Club Foot, Torticollis, Metatarsus Adductus
What are the signs/symptoms of CDH?
Pain in Groin
Anterior Thigh pain or Knee pain
Decreased Activity Level
History of hip dislocation or subluxation
What is the treatment for CDH?
Bracing (pediatric population)
Corticosteroid injections (Under Fluoro)
Osteotomy--> try to replace the acetabulum, not really used anymore
Total Hip Arthroplasty
What are two tests that might suggest a hip dysplasia?
Barlow Maneuver (dislocatable hip)
Ortolani Maneuver (relocates the hip)
What is Hip Protrusio? and what disease states do we see it with
Movement of the femoral head into the acetabulum
What are the signs of Hip Protrusio?
what is the treatment?
Leg Length Discrepancy
what is Legg-Calve-Perthes?
-Temporary develop AVN Femoral Head
---->Egg shape development of femoral head
Self Limited Disease
who does legg-calve-perthes affect?
3-12 Years of Age
Increase incidence 4-6 years of age
More Common in Males
What are the signs and symptoms of legg-calve-perthes
Pain in Anterior Thigh or Knee
Presents with a Limp
Leg Length discrepancy
What is the treatment for legg-calve-perthes?
NEED TO DO MRI TO EVAL FOR BLOOD FLOW
Braces for 2-3 years (Abduction)
Total Hip Arthroplasty
What is Slipped Capital Femoral Epiphysis, and who is it common in?
Weakening of the Epiphysis Plate
Displacement of Growth Plate
common in boys 11-16
what are the body type risk factors for SCFE? what does it put those at risk for later in life?
Tall, slender, and rapid growth
Obese and underdeveloped sex characteristics
Risk factor for Early Osteoarthritis
what are the signs of SCFE?
Pain with Weight Bearing
Groin, Thigh, or Knee Pain
Pain with Extremes of Motion
Unable to Internally Rotate
What is klein's line?
Line drawn parallel to the superior border of the femoral neck
Epiphysis should project superiorly to the line
is SCFE an ortho emergency?
yes!!! needs to be pinned!!
What is the treatment for OA?
Modify Activity Level
Weight Loss (1lb = 3lbs pressure)
Use of an assistive device
Long Term NSAIDs
Cortisone Injections (Fluoroscopy)
What are some of the risks associated with choosing a total hip arthroplasty as the means of fixing an OA hip?
Deep venous thrombosis: 6%
Pulmonary embolisms: 0.3%
Nerve palsies or neuropraxia: 1%
What long term complications can come from a total hip arthroplasty?
5-7% Failure within first 10 years
Increased Failure Risk
What are some of the causes for AVN of the femoral head?
90% unknown etiology
What the most common cause of AVN to the femoral head?
what are the three types of hip fractures?
most hip fractures are explained by what two things?
1. underlying bone mass
after a hip fracture, an individual is a t a high risk for?
what is a trochanteric bursitis?
Mechanism: Compression, Trauma, or Overuse
(due to all the muscle attachments in that area)
What signs will you see with a trochanteric bursitis? what test will be positive? what will be negative?
Pain Located Lateral Side
Generally Very Tender
Positive Ober’s Test
X-rays are Negative
what are symptoms with a gluteus tendon rupture?
same as trochanteric bursitis