Common Problems of the Hip

Question 1

What is a dynamic hip screw?

Answer 1

allows controlled dynamic sliding of femoral head component along construct – performed when intertrochanteric fracture present

Question 2

What is a hemiarthroplasty?

Answer 2

surgical procedure that replaces one half (ball portion) of hip joint with a prosthesis

performed on hip after a subcapital (just below head) fracture of the neck of the femur

Question 3

What is a total hip replacement?

Answer 3

2 basic components: ball component (made of a highly polished strong metal or ceramic material) and socket component (a durable cup of plastic/polyethylene, ceramic, or metal)

performed when osteoarthritis of the entire hip

Question 4

Describe posterior hip dislocation due to trauma

Answer 4

Tear through joint capsule where it’s at its weakest = weakened limb shortened and medially rotated, risk of sciatic nerve injury that runs posterior to joint

Question 5

Describe anterior hip dislocation due to trauma

Answer 5

As consequence of traumatic extension, abduction and lateral rotation. = often associated with fractures of femoral head

Question 6

Describe the common features of a pelvic fracture

Answer 6

2 common ways = direct trauma (vehicle accident), force from lower limb (heavy fall on feet).

Fracture often at weak areas = pubic rami, acetabulum, sacroiliac joint.

Common soft tissue injury = bladder, urethra

Question 7

Outline the common characteristics of a proximal femur fracture extracapsular

Answer 7

Common in elderly/women, result of stumble, can damage femoral circumflex artery = avascular necrosis of femoral head.

Shorter leg = distal frag pulled superior/lateral, with toe pointing laterally

Question 8

outline the common characteristics of a proximal femur fracture intracapsular

Answer 8

common in young/middle aged, blood supply intact, leg shortened and laterally rotated

Question 9

Describe a fracture of the femoral shaft

Answer 9

Relatively uncommon, require a lot of force = vehicle injury, spiral fracture = leg shortening = fragments pulled by attached muscles, femoral nerve/artery may have been damaged.

Question 10

How does a hip fracture vs a hip dislocation present?

Answer 10

Fracture
• Leg is shortened and externally rotated

Dislocation
• Leg is shortened and internally rotated