Hip Flashcards
Descrbe new born hip
hip flexion of 30
Total rom is 170
pelvis is small and posteriorly tilted
The acetabular cup is shallow and angled downwards 7 degree
what are the newborn hip Rom for different position?
Flexion130
Extention 0
Abduction is 80
Adduction is 20
Medial rotation is 80
lateral rotation is 90
describe the development of hip ROM?
by 4-6 months the hip joint can be extended
1st-year flexion contracture and excessive external rotation have reduced
Hip joint rotation decreases by 12-20 each decade for the 1st 20 years and 5 degrees per decade afterward
till 2 years external rotation is greater than internal rotation
by 3 rd year, the acetabulum cups deepens and angle downwards 17
Also see slide 5 of the lecture
Hip ROM assessment
1-supine position-flex hip and knee at 90 degrees. watch pelvis for movement or increased lumbar lordosis
2- supine simply observe the lordosis angle
Hip ROM assessment-Flexion
- Modified Thomas test
flex both hip joints to remove lordosis
Extend one leg whilst keeping the other flexed
at point of pelvic movement or increase lordosis
the angle between extended thigh and plinth
hip ROM assessment-extension
Staheli’s prone hip extension test
hip joint flexed over the end of the plinth ( flattens lordosis)
handover lumbosacral region
lift thigh
the angle between the thigh and plinth
angle by which the hip is unable to reach neutral ( parallel to the plinth). degree of flexion deformity/contracture
what is the position of the hip and knee for abduction measurement?
abduction assessed with the pt knees and hips in 90 degrees of flexion
Positive trendlenberg test
dropping of the pelvis. elevated leg. lateral arching to the supporting leg
what is DDH?
femoral head has an abnormal relationship to the acetabulum
it happens due to dislocation, subluxation, and tratologic dislocation.
DDH aetiologies
-ligamnetous laxity
-Genetic predisposition, greater ratio of collagen type 3 vs collagen type 1.
Maternal relaxin crossing the placenta
-prenatal positioning :
double flexed breech
1st born child
post natal positioning
DDH associations
Torticollis 15-20
Metatarsus adducts
Oligohydramnios
DDH assessment
Barlow
Ortalani
Klisic
Decreased abd
Galezzi’s sign
Asymmetry of thigh folds+gluteal line
Barlow test
small abd, push posteriorly
Positive: feeling of HOF jump out of acetabulum and when released will go back in.
Ortolani test
gentle flexion and abd whilst lifting up on the greater trochanter.
Positive: a palpabe clunkas the HOF falls back into the acetabulum
Klisic test
Finger over ASIS and the greater trochanter
