Hip And Pelvis

Question 1

What are the three cardinal signs of degenerative joint disease?

Answer 1

Asymmetrical loss of joint space

Subchondral sclerosis

Osteophytes

Question 2

What was the previous name of DJD?

Answer 2

Osteoarthritis or OA

Question 3

Stats from Temple U:

Hip fix have 2x over the past 20 years.
Contributing to that is a sedentary lifestyle leading to loss of bone strength, endurance and flexibility.

What is the current number of hip fx a year?

Answer 3

400,000 fx/year

Question 4

Stats from Temple U:

What is the fraction of men and women over 80 suffering for hip fx?

Answer 4

1/3 women

1/9 men

Question 5

Stats from Temple U:

What percentage of those with hip fx over 80 will die within a year?

What percentage of those with hip fx over 80 will be discharged to a nursing home?

Answer 5

25% die within a year

75% survivors go to nursing home

Question 6

How do our patients present with hip fx?

Answer 6

Difficulty or inability to ambulate(move about)

Groin pain

Externally rotated hip

Shortened leg

Question 7

Hip fx can be intracapsular or extracapsular. What is the difference or what sets them apart?

Answer 7

Intracapsular Fx could involve the blood supply from the circumflex arteries and lead to a vascular necrosis.

Question 8

Garden Classification Type I️

Answer 8

Incomplete, undisplaced femoral head

Question 9

Garden classification Type II

Answer 9

Complete, undisplaced femoral head

Question 10

Garden Classification Type III

Answer 10

Complete, partially displaced femoral head

Question 11

Garden Classification type IV

Answer 11

Complete fx, complete displacement of femoral head

Question 12

Management options for hip fx.

Answer 12

Dynamic hip screw
Cannulated hip screw
Total or hemi hip arthroplastly
Cemented or uncemented

Question 13

Hip Fx management:

Lag screw through the femoral head and neck and lateral femoral plate.

Allows controlled dynamic sliding of femoral head and component along the head component

Primary healing

Answer 13

Dynamic hip screw or sliding screw

Question 14

Hip Fx management:

Screw through femoral neck and head.

Stabilizes intracapsular factor and allows healing in hopes that blood supply on inside is preserved

Answer 14

Cannulated

Question 15

Hip Fx Managment :

Replacement of femoral head but not acetabulum

Shorter operation for older less active pt

Answer 15

Hemi arthroplasty

Question 16

Hip Fx management :

Replacement of hip and acetabulum

Complicated

Robust

10-15 yr lifespan after

Answer 16

Total hip arthroplasty

Question 17

Hip Fx Managment:

What would be the reason for cemented repair?

Answer 17

Older age

Relatively inactive

Low physiological reserve

Osteoporosis or weakened bones

Question 18

Hip Fracture Management:

What would be the reason for uncemented repair?

Answer 18

Young age

Active person

high physiological reserve

Longer lasting

Question 19

Chiropractic Management of hip fx

Answer 19

Stabilize/Monitor

Call 911

Cell ED

Speak with ED physician

Prepare file for transport

Maintain your office

Question 20

Anvil test

Answer 20

Positive: Localized pain in long bone or in hip joint

Indicates: Possible fracture of long bones, or hip joint pathology.

Question 21

Patrick test or Fabere sign

Answer 21

Positive: Pain in the hip region.

Indicates: Hip joint pathology.

Question 22

Laguerre test

Answer 22

Positive:

(1) Pain in the hip joint
(2) Pain in the sacroiliac joint.

Indicates:

(1) Hip joint pathology
(2) Mechanical problem of the sacroiliac joint

Question 23

Hibb test

Answer 23

Positive:
(1) Pain in the hip region.

(2) Pain in the buttock/pelvic region.

Indicates:

(1) Hip joint pathology.
(2) Sacroiliac joint lesion.