HIP DISLOCATION

Question 1

TYPE

Answer 1

POSTERIOR
ANTERIOR
CENTRAL

Question 2

POSTERIOR DISLOCATION

Answer 2

HEAD OF FEMUR PUSHED OUT POSTERIORLY

Question 3

MECHANISM

Answer 3

DASHBOARD INJURY -
FORCE ALONG LONG AXIS OF FEMUR AND PUSHES FEMORAL HEAD OUT OF SOCKET POSTERIORLY

Question 4

CLINICAL FEATURES

Answer 4

HISTORY OF TRAUMA
PAIN
SWELLING
DEFORMITY= FLEXION ADDUCTION ANDD INTERNAL ROTATION
RESTRICTED MOVEMENT
SHORTENING OF LIMB
HEAD FELT IN GLUTEAL REGION

Question 4

IMAGING

Answer 4

X RAY
CT SCAN

Question 5

X RAY

Answer 5

AP VIEW =
SHENTONS LINE DISRUPTED
LESSOR TROCHANTER LESS VISIBLE
FEMORAL HEAD OUT OF SOCET AND ABOVE AND BEHIND ACETABULUM
ASSOCIATED FRACTURE OF ACETABULUM
OBLIQUE VIEW =
SIZE OF FRACTURE FRAGMENT

Question 6

CLASSIFICATION ( THOMPSON AND EPSTEIN CLASSIFICATION )

Answer 6

( WRITE IN ROMAN NUMBER )
TYPE 1 = DISLOCATION WITH NO M ORE THAN CHIP FRACTURE
TYPE 2 = DISLOCATION WITH SINGLE LARGE FRAGMENT OF POSTERIOR ACETABULAR WALL
TYPE 3 = DISLOCATION WITH COMMINUTED FRACTURE OF POSTERIOR ACETABULAR WALL
TYPE 4 = DISLOCATION WITH FRACTURE THROUGH ACETABULAR FLOOR
TYPE 5 = DISLOCATION WITH FRACTURE THROUGH ACETABULAR FLOOR AND FRACTURE OF FEMORAL HEAD.

Question 7

TREATMENT

Answer 7

TYPE 1
TYPE 2 - ORIF
TYPE 3 - CLOSED REDUCTION, IF FRAGMENTS RETAINED THEN OPEN REDUCTION
TYPE 4 AND 5- CLOSE REDUCTION , IF UNSTABLE HIP AND FRAGMENTS RETAINED OPEN REDUCTION

Question 8

TYPE 1

Answer 8

CLOSED REDUCTION ( ALLIS TECHINIQUE ) AND TRACTION FOR 6 TO 12 WEEKS

Question 9

ALLIS TECHNIQUE

Answer 9

PATIENT ANESTHETISED AND PLACED SUPINE ON FLOOR
ASSISTENT GRAPS PELVIS
SURGEON FLEXES THE HIP AND KNEE AT RIGHT ANGLE
EXERTS PULL ALONG THE LONG AXIS OF FEMUR
IF SOUND HEARD - HIP REDUCED , MOVES FREELY

Question 10

COMPLICATION

Answer 10

EARLY =
SCIATIC NERVE INJURY
GLUTEAL ARTERY INJURY
ASSOCIATED FRACTURE OF FEMORAL SHAFT
LATE =
AVN
MYOSSITIS OSSIFICANS
UNREDUCED DISLOCATION
OSTEOARTHRITIS
RECURRENT DISLOCATION