Hip Flashcards by Lili Popp

ROM normal values of hip Flexion, Extension, Abduction, Adduction, IR, and ER

Flexion: knee ext; 0-90 degrees;
*flexed knee: 0-120 degrees
Extension: 0-20 degrees
Abduction: 0-45 degrees
Adduction: 0-40 degrees
IR & ER: 0-45 degrees

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What type of Joint is the hip joint?

multiaxial, ball and socket joint
*aka COXOFEMORAL JOINT

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Capsular Pattern of the hip joint

Flexion, Abduction, Medial rotation [FABIR]

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Resting position of the hip joint

FABER [30 Flex, 30 ABd, slight ER]

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Closed packed position of the Hip joint

Full extension, Medial Rotation, Abduction [EABIR]

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What is the most common direction of dislocation of the Hip joint?

Posterior

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Triad of Dashboard injury

Injury over the knee (PCL injury)
Injury over the symphysis pubis
Posterior hip dislocation

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The “vinegar cup is formed by the innominate bones, what are the exact bones?

Formed by 3 bones:
1/5 pubis
⅖ ilium
⅖ ischium

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Line formed at the lateral edge of the acetabulum as compared to vertical line forming femoral head
Normal (?) degrees

Center edge angle: WIBERG
Normal: 25-45 degrees

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CENTER EDGE ANGLE or ACETABULAR ANTERVERSION ANGLE
ACETABULAR COVERING IN RELATION TO FEMUR: Covers the front of the femoral head

ACETABULAR ANTERVERSION ANGLE

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Normal value of the Acetabular anteversion angle

Normal: 15-20

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Orientation of the accetabulum

Anterior-lateral-inferior
*Orientation: “ALIng Ceta”

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all of these describes the ACETABULAR LABRUM, EXCEPT:
- Dense, horseshoe-shaped fibrocartilaginous
stabilizes the hip during extreme ROM
- Provides proprioceptive information for dynamic stability
- Increases Knee area and volume for acetabulum
- Creates a seal for the central compartment, part of the intra-articular hip joint

Increases Knee area and volume for acetabulum
*Increases articular surface area and volume for acetabulum

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CENTER EDGE ANGLE or ACETABULAR ANTERVERSION ANGLE
DECREASED
Retroverted over coverage
Coxa profunda
Acetabular protrusion
LOM and impingement

ACETABULAR ANTERVERSION ANGLE

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T or F
LEGG CALVE-PERTHES DISEASE: 3-12 y/o boys
SCFE: 10-17 yrs old, boys

TRUE

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CENTER EDGE ANGLE or ACETABULAR ANTERVERSION ANGLE

LANDMARKS
Oblique line from lateral rim of acetabulum
Vertical line form center of fem head

CENTER EDGE ANGLE

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What is the main blood supply of the Femur?
(in children and in adults)

Child: Retinacular artery
.
Adult: Retinacular artery and Obturator artery via ligamentum teres and metaphysial

CORRELATED POSTURE
Toeing out, Subtalar supination, Lateral tibial torsion, Lateral femoral torsion

EXCESSIVE RETROVERSION

CENTER EDGE ANGLE or ACETABULAR ANTERVERSION ANGLE
INCREASED
Over coverage:
Coxa profunda
Acetabular protrusion
LOM and impingement

CENTER EDGE ANGLE

MOI: land on the outside of the hip

Trochanteric bursitis (possible)

CORRELATED POSTURE
Toeing in, Subtalar pronation, Lateral patellar sublaxation, Medial tibial torsion, Medial femoral torsion

EXCESSIVE ANTERVERSION

Avascular necrosis in child? In adult?

Child: LCPD (Legg-Calvé-Perthes disease)
Adult: Chander’s dse

Values of Coxa valga and Coxa vara

Coxa valga (>135 degrees)
Coxa vara (<120 degrees)

Where is the Elicitation of pain for these:
ANTERO-POSTERIOR IMPINGEMENT
Posteroinferior Impingement:

ANTERO-POSTERIOR IMPINGEMENT: Elicitation of pain: flexion and IR
.
Posteroinferior Impingement: Elicitation of pain: extension and ER

These are advantage of Coxa? Improve hip joint stability Increases coverage from acetabulum Good length tension relationship for hip abductors

Coxa vara (<120 degrees)

Orientaion of the Femur

Superior, Anterior, Medial

T or F Subluxation, acetabular, labral tear:land on or hit the knee, thus jarring the hip Femoral stress fracture: land on or hit the knee, thus jarring the hip

FALSE Subluxation, acetabular, labral tear: land on or hit the knee, thus jarring the hip Femoral stress fracture: involved in repetitive loading activity

CORRELATED POSTURE Pronated subtalar joint, Medial rot of leg, Short ipsilateral leg, Anterior pelvic rot

COXA VARA

PNI, What nerve is affected? Cause of injury: during child birth ant disloc of hip Surgery over the hip (hernia) Manifestation: affectation/ weak quads Paresthesia over the distribution

FEMORAL NERVE

PNI, What nerve is affected? Site of management over inferior border of gluteus minimus muscle or sometimes piriformis Manifestation: trendelenberg sign (pelvis drop)

SUPERIOR GLUTEAL NERVE

The disadvantage of Coxa vara

Prone to femoral neck fx Prone to slipped capital femoral epiphysis Leg length discrepancy d/t shortened leg

CORRELATED POSTURE Supinated subtalar joint, Lateral rotation of the leg Long ipsilateral leg, Posterior pelvic tilt

COXA VALGA

PNI, What nerve is affected? Cause of injury impingement during pregnancy, fx, tumor, surgery, direct trauma, pain over the groin Manifestation: pt will experience weakness over adductor muscle grp Paresthesia over obturator nerve distribution

OBTURATOR NERVE

PNI, What nerve is affected? Largest Pelvis or upper femur area Piriformis syndrome Pain and weakness on abd and ER of hip Sign of pace and Nagel Freiberg sign Impingement of

SCIATIC NERVE

What are and the structure affected : True leg length Apparent leg length

True leg legnth/true shortening (bone is affected) Apparent leg length/functional shortening (muscle is affected)