Dislocations in the Lower Limb Flashcards
What type of injuries are hip dislocations associated with?
What other injuries may occur with a hip dislocation?
How are these treated?
What are the risks?
This injury may press on what nerve?
High energy injuries
Posterior wall of acetabulum fracture or femoral head avulsion fracture
Emergency reduction (maybe internal fixation)
AVN and hetrotrophic ossification
Sciatic nerve
In what directions can prosthetic hip joints dislocate?
This may involve a tear in which muscles?
How are these treated the first time around?
How are these treated if they happen again?
Anterior or posterior
Abductors
Knee splint
Revision surgery
Where will patients with a patellar dislocation have pain? Why?
What may form within a short time of the injury?
Medial retinaculum- where the medial patellofemoral ligament has torn
Haemarthrosis
What direction is the patella most likely to dislocate in?
Why does this occur?
How can these be reduced?
What type of fracture can sometimes occur with this? What can this show on x-ray?
Lateral
Sudden quads contraction with rotational force or a direct blow
When the leg is straightened or manually
Osteochondral- lipohaemarthrosis/foreign body
What are the factors predisposing to patellar dislocation?
< 20
Female
Ligamentous laxity
Genu valgam
Shallow trochlea
Femoral neck anterversion
How do you treat a patellar dislocation?
What is the recurrence rate with the first dislocation, and then the second?
What stabilisation can be offered?
Spint for 3 weeks and physio to strengthen the vastus medialis
10%, 50%
MPFL reconstruction or bony procedure if malalignment
What are some causes of a knee dislocation?
There is a high incidence of what complications?
High energy injuries/severe hyperextension and or rotational forces
Popliteal artery and common fibular nerve injury, compartment syndrome
What is a LisFranc dislocation?
How will these patients present?
What is the mechanism of injury?
What imaging may be needed?
A fracture of the base of the 2nd metatarsal is associated with a dislocation there
Grossly swollen and bruised foot on which they cannot weight bear
Rotation of a hyper-plantarflexed foot
CT (often cannot be seen on x-ray)
