Heup Flashcards
(30 cards)
Trajectionele structuur bot heup
Ward driehoek: compressie en tensie lijnen.
Meer bij coxa vara, minder bij coxa valga.
Sourcil
Vorm = diagram van drukspanning
Alpha angle
Normal 42 graden
Pathologisch >61 graden
CEA
Normaal 20-25 graden
Dysplasie <20 graden
Pincer > 39 graden
HEER test
Hyper exetension and external rotation.
Micro instability testing bij heup impingement.
Risicofactoren AVN heup
Trauma
Chemotherapie, radiotherapie
Hemoglobinopathien (sikkelcel anemie)
Luchtembolen
Roken
Alcohol
Corticosteroiden
Nierlijden
Genetisch
Zwangerschap
Lupus
NIET diabetes
Acetabulum loosening op Rx?
De Lee zones
Femur tekenen van loosening op Rx
Gruen zones
Functies van steel van feurprothese
- rotatie stabiliteit
- varus voorkomen
- subsidence voorkomen
- allignement
Concept dual mobility
Low friction thv klein kopje (80% van beweging is hier)
Meer stabiliteit door grote kop. (Klein kopje is constrained in grote kop)
Voorwaarden hip resurfacing
Head size >50mm
Leeftijd <55j
Man
Deformity femur hip revision technique
Medial osteotomy and crush plasty
Post SCFE deformiteit behandeling
- Dunn osteotomie: subcapitaal (trochanter osteotomie en extended retinacular flap)
- Imhäuser osteotomie: interrrochanter => flexie, valgus en derotatie
Anterior center edge angle
Lateral center adge angle
Acea: false profile hip. Normaal 20-45 graden
Lcea: AP hip. Normaal 20-40
Femur osteotomie dysplasie
Variserende interteochantere osteotomie
- Xrays in abduction
Osteotomie femur artrose
Interterochantere valgus osteotomie
Mediale osteofyt en laterale overload
Salter osteotomy
Single transverse cut above the acetabulum through the ilium to sciatic notch
Acetabulum hinges through the pubic symphysis
Improves anterolateral coverage (can provide 20-25° lateral and 10-15° anterior coverage)
May lengthen leg up to 1cm
Triple osteotomy
Salter osteotomy plusadditional cutsthrough superior and inferior pubic rami
Acetabular reorientation procedure
Improves anterolateral coverage
Pao Ganz osteotomy
Involves multiple osteotomies in the pubis, ilium, and ischium near the acetabulum
Allows for improved 3D correction of the acetabulum configuration
Technically the most challenging
Posterior column and pelvic ring remain intact
Patients are allowed to weight bear early
Dega osteotomy
Osteotomy from acetabular roof to triradiate cartilage (incomplete cuts through pericapsular portion of the innominate bone)
Acetabulum hinges through the triradiate cartilage
Does not enter the sciatic notch and is therefore stable and does not need internal fixation
Improves anterior, central, or posterior coverage
Reduces the acetabular volume
Shelf osteotomy
Salvage.
Add bone to the lateral weight-bearing aspect of the acetabulum by placing an extra-articular buttress of bone over the subluxed femoral head
Depends on fibrocartilage
metaplasia for successful results
Chiari osteotomy
Salvage
Osteotomy starts above the acetabulum to the sciatic notch and ileum is shifted lateral beyond the edge of the acetabulum
Depends on fibrocartilage
metaplasia for successful results
Medializes the acetabulum via iliac osteotomy
Iliac oblique view
Obturator oblique view
Iliac: anterior wall + posterior column
Obturator: posterior wall + anterior column
Judet views
Congenitale varus heup (pediatrisch): type osteotomieën?
Wigosteotomie: onvoldoende correctie van hoek fyse => risico herval
Y-osteotomie: fyse horizontaal => enkel compressie krachten
