Disorders of the Hip/Pelvis Flashcards Preview

MED: Ortho/Rheum > Disorders of the Hip/Pelvis > Flashcards

Flashcards in Disorders of the Hip/Pelvis Deck (33):
1

What are the two main types of hip dislocations? what type of accidents do they occur in?

1. anterior
2. posterior

high energy accidents

2

which of the two types of hip dislocations is more common?

posterior

3

describe posterior hip dislocations:

Most common
Mechanism:
Hip typically in a flexed position
Leg typically shortened, adducted, internally rotated

4

Describe anterior dislocations:

Mechanism
Hip extension and external rotation
Hip is flexed, abducted, and externally rotated

5

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
Crutches
Physical Therapy

6

What is congenital dysplasia of the hip

Shallow development of acetabulum

7

what are you at risk for with CDH? what puts you at risk for CDH?

Increased risk of dislocations
Increased risk of Osteoarthritis (OA)

Firstborn
Breech Birth or Breech Presentation
Associate with Club Foot, Torticollis, Metatarsus Adductus

8

What are the signs/symptoms of CDH?

Pain in Groin
Anterior Thigh pain or Knee pain
Hyper mobile
Decreased Activity Level
History of hip dislocation or subluxation

9

What is the treatment for CDH?

Conservative :
Bracing (pediatric population)
NSAIDs
Corticosteroid injections (Under Fluoro)
Modify activity

Surgeries:
Osteotomy--> try to replace the acetabulum, not really used anymore
Hip resurfacing
Total Hip Arthroplasty

10

What are two tests that might suggest a hip dysplasia?

Barlow Maneuver (dislocatable hip)
Ortolani Maneuver (relocates the hip)

11

What is Hip Protrusio? and what disease states do we see it with

Movement of the femoral head into the acetabulum

Osteoarthritis
Infection
Tumors
Paget’s disease

12

What are the signs of Hip Protrusio?
what is the treatment?

PAIN
Hip Impingment
Hip Contracture
Trendelenburg limp
Leg Length Discrepancy
tx: surgery

13

what is Legg-Calve-Perthes?

-Temporary develop AVN Femoral Head
---->Egg shape development of femoral head
Self Limited Disease
Unknown Etiology

14

who does legg-calve-perthes affect?

3-12 Years of Age
Increase incidence 4-6 years of age
More Common in Males

15

What are the signs and symptoms of legg-calve-perthes

Pain in Anterior Thigh or Knee
Groining Pain
Presents with a Limp
Decrease ROM
Abduction
Internal rotation
Leg Length discrepancy

16

What is the treatment for legg-calve-perthes?

NEED TO DO MRI TO EVAL FOR BLOOD FLOW
Treatment
Braces for 2-3 years (Abduction)
Osteotomy
Total Hip Arthroplasty

17

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

18

what are the body type risk factors for SCFE? what does it put those at risk for later in life?

Body Type
Tall, slender, and rapid growth
Obese and underdeveloped sex characteristics
Risk factor for Early Osteoarthritis

19

what are the signs of SCFE?

Pain with Weight Bearing
Groin, Thigh, or Knee Pain
Pain with Extremes of Motion
Unable to Internally Rotate

20

What is klein's line?

Line drawn parallel to the superior border of the femoral neck
Epiphysis should project superiorly to the line

21

is SCFE an ortho emergency?

yes!!! needs to be pinned!!

22

What is the treatment for OA?

Ice
Modify Activity Level
Weight Loss (1lb = 3lbs pressure)
Use of an assistive device
Long Term NSAIDs
Cortisone Injections (Fluoroscopy)
Surgery

23

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%
Infections: 3%
Nerve palsies or neuropraxia: 1%

24

What long term complications can come from a total hip arthroplasty?

Aseptic Loosening
5-7% Failure within first 10 years
Polyethylene Wear
Dislocation 4%
Increased Failure Risk

25

What are some of the causes for AVN of the femoral head?

Hip fx
Alcoholism
Prednisone
Diabetes
Sickle cell
90% unknown etiology

26

What the most common cause of AVN to the femoral head?

unknown etiology

27

what are the three types of hip fractures?

Femoral Neck
Intertrochanteric
Subtrochanteric

28

most hip fractures are explained by what two things?

1. underlying bone mass
2. age

29

after a hip fracture, an individual is a t a high risk for?

mortality

30

what is a trochanteric bursitis?

Mechanism: Compression, Trauma, or Overuse
(due to all the muscle attachments in that area)

31

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

32

what are symptoms with a gluteus tendon rupture?

same as trochanteric bursitis

33

how do you diagnose a gluteal tendon rupture?
whats the treatment?

MRI
surgery is only treatment