Disorders of the Hip/Pelvis Flashcards
(33 cards)
What are the two main types of hip dislocations? what type of accidents do they occur in?
- anterior
- posterior
high energy accidents
which of the two types of hip dislocations is more common?
posterior
describe posterior hip dislocations:
Most common
Mechanism:
Hip typically in a flexed position
Leg typically shortened, adducted, internally rotated
Describe anterior dislocations:
Mechanism
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 Crutches Physical Therapy
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)
Firstborn
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 Hyper mobile Decreased Activity Level History of hip dislocation or subluxation
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
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
Osteoarthritis
Infection
Tumors
Paget’s disease
What are the signs of Hip Protrusio?
what is the treatment?
PAIN Hip Impingment Hip Contracture Trendelenburg limp Leg Length Discrepancy tx: surgery
what is Legg-Calve-Perthes?
-Temporary develop AVN Femoral Head
—->Egg shape development of femoral head
Self Limited Disease
Unknown Etiology
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 Groining Pain Presents with a Limp Decrease ROM Abduction Internal rotation Leg Length discrepancy
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
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?
Body Type
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?
Ice Modify Activity Level Weight Loss (1lb = 3lbs pressure) Use of an assistive device Long Term NSAIDs Cortisone Injections (Fluoroscopy) Surgery
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%
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
