Hip disorders Flashcards
Decribe where the main blood supply to femoral head is
where is a minor source in adults but major in children?
Arising from the base of the femoral neck there are medial and lateral femoral arteries that supply the head
in children and adults there is a an artery of ligamentum teres- it is more important in children as the epiphyte always growth plate is still present
What is osteoarthritis?
primary?
secondary?
It is a chronic condition of the joint where the cartilage is worn down so bone rubs on bone = painful
primary osteoarthritis = unknown cause it risk factors are identified e.g. age gender ethnicity genetics nutrition
secondary osteoarthritis = know cause :obesity, trauma , infection, cancer
Talk me through how osteoarthritis develops
- Risk factors lead to excessive loading and wear f the articular cartilage
- in an initial attempt to repair cartilage, proteglycans are released by chondrocytes
- there is flaking of cartilage
- there is erosion of cartilage down to subcondral bone and reduced joint space
- This them causes thickening of the bone, osteophytes and bone cysts
what are symptoms of hip osteoarthiritis?
- joint stiffness
- pain, swelling, tenderness
- cunching (crepitus)
- reduced ability to move
diagnoses by signs and symptoms and also imaging
what are non operative forms of managing osteoarthiritis?
lifestyle:
- lower activity
- loose weight
- use a walking stick
- physiotherapy
medication:
- NSAIDS (reduce pain and fnflammation)
- COX-2 inhibitors (anti inflammatory)
- nutritional supplements
injections:
- corticosteroid (anti inflammatory), vascosupplementation (slows arthritis = hylauronic acid)
what is a surgical procedure to treat osteoarthiritis of the hip?
what are the benefits?
hip replacement surgery
reduces pain and improves well being and restores mobility
what are the 2 main categories of hip fracture?
what areas are hese fracture in?
intracapsular and extracapsular
intra = femoral neck
extra = trochanteric fracture and subtrochanteric
what are the symptoms of a hip fracture?
what are the signs?
why do we get this sign?
- reduced mobility
- cant weight bear
- pain in hip, groin or knee
- short externally rotated leg
we get this as the recus femoris and adductor megnus contract = short
and all the gluteals cause external rotation
what type of hip fracture effects the blood suppy and why?
displaced intracapsular
as the femoral head blood vessels run along the neck therefore fracturing this area may cut off theblood suppt and cause internal bleeding
can cause avascular necrosis
what can cause avascular necrosis ?
- broken hip
- hypertension
- alcoholism
- steroids
- blood clot
- post trauma
what 3 types of hip dislocation can you get?
- posterior hip dislocation
- anterior hip dislocation
- central hip dislocation
what is the most common hip dislocation?
what are the signs/symptoms?
what nerve can it damage?
what mechanism of injury s common
posterior dislocation - femur slips behind acetabulum
short internally rotated leg
adducted
flexed
sciatic = sciatic nerve palsy
car crash and hit knee on dashboard
decribe the anterior hip dislocation
symptoms/signs please
what nerve can it rarely damage?
the femoral head has popped forward
externally rotated
abducted
flexed
femoral nerve
decribe a central dislocation
signs and symptoms
head is driven through socket
always causes fracture
intrapelvic haemorrhage
femoral head palpable through rectum
