Hip Flashcards
(30 cards)
What is congenital hip dysplasia, and its cause?
Sublux due to breech delivery
-abnormal lax hip capsule
CHD usually results in a muscle contracture of which group?
Adductors (short)
-2* hip drop from dysplasia
What two maneuvers can be used to test for CDH?
Barlow maneurver
- dislocation
- adduction
Ortolani Test
- relocation
- abduction
What position should the hip be in to correct CDH and what is the brace called?
fxn, abd
Pavlik Harness
What is Legg-Calve-Perthes Disease? What is its pathophysiology?
Osteonecrosis of femoral head.
-idiopathic
5M:1F
15% B
Arteries occluded, subchondral bone dies
- revascularized over time
- subchondral bone can fx without protection
What does LCPD look like on imaging? What are some early signs?
Can present as crescent sign of subchondral collapse.
Antalgic gait, hip pain
adductor spasm
What are the stages of LCPD?
- Necrosis
- Fragmentation
- reabsorb bone - Re-ossification
- new bone - Remodeling
In what orientation should a leg with LCPD be braced?
IR and ABD
Scottish Rite orthosis
What Salter-Harris grade is a Slipped Capital Femoral Epiphysis (SCFE)? What direction does it move?
grade 1 epiphyseal slip
- sublux posterior-inferior
- Flattened femoral head
Who is most affected by SCFE?
2.5M:1F
10-16 yo
-short/fat
-tall/thin
Gradual onset
-quad atrophy
How do you grade SCFE?
By how much the femoral head has slipped off the neck
- 50%
Chronic SCFE injuries are most common. How long until one can resume regular activities?
3-6 months.
-NWB first 6 weeks
Septic hip is a rapidly progressing joint infection with considerable effusion and is very hot in <2 yo. What orientation is the hip in?
FABER
Flexion
Abduction
ER
What are a few chronic avulsion fracture sites in youth?
AIIS
ASIS
Greater troch
Lesser troch
Hip OA usually limits motion in a capsular pattern. Which surfaces of the hip are usually destroyed in OA?
FEMORAL HEAD
Posterior
Superior
ACETABULUM
What is the capsular pattern of the hip?
IR > FXN > ABD
What types of surgery are available for hip OA?
Arthroplasty Osteotomy (usually varus) -wedge from medial femoral shaft to change weight bearing surface
Arthrodesis (fusion)
Anterolateral approach to THR dissects the gluteus medius. What is the restrictions?
Limit extension, ADD, ER
A trans-trocahnteric approach osteomizes the greater troch. What are it’s restrictions?
Ext/add/IR
What are some complications post THR?
Infection
DVT
Dislocaiton
Loosening of cement
In what position is a hip usually fused for arthrodesis?
Neutral ABD
ER = 0-30
FXN = 20-25
Orientation minimizes lumbar motion.
What typically causes osteonecrosis?
Subchondral bone death.
Which artery supplies the femoral head?
Medial circumflex.
What is the crescent sign of AVN?
1st area of hyperluscency in fem head around articular surface. Bone later dies and collapses down.
