Chapter 98 - Hip Dislocations and Femoral Head Fractures

Question 1

drawback of the kocher langenbeck approach to femoral head fractures

Answer 1

limited access to femoral head articular surface

Question 2

mechanism of injury of a anterior dislocation

Answer 2

• abduction and external rotation
  flexed hip: obturator dislocation
  extended hip: superior dislocation

Question 3

mechanism of injury in a posterior dislocation

Answer 3

flexion, abduction, internal rotation
higher degrees of flexion favor pure dislocation over added posterior wall fracture

Question 4

very strong correlation between hip dislocation and what additional injury?

Answer 4

ligamentous or bony ipsilateral knee injury

Question 5

for irreducible or otherwise surgically indicated hip dislocation, what approach should you use?

Answer 5

one in the direction of the dislocation (bc thats where capsule is already demolished)
- eg kocher for a posterior dislocation, smith pete for an anterior

Question 6

sciatic nerve injury in hip dislocation commonly affects which division?

Answer 6

peroneal nerve division

Question 7

pipkin classification of femoral head fractures

Answer 7

I: infrafoveal
II: suprafoveal
III: with a femoral neck
IV: with an acetabulum fracture

Question 8

what pipkin classification is most commonly complicated by osteonecrosis of the femoral head?

Answer 8

pipkin III (femoral head plus neck)
and it occurs within one year of injury

Question 9

what finding significantly increases the rate of posttraumatic OA in an acetabular lesion

Answer 9

femoral head cartilage lesion