Hip

Question 1

What is a stable pelvic fracture?

Answer 1

At most one fracture through the pelvic ring.

Question 2

What are 3 types of stable pelvic fractures?

Answer 2

• Avulsions
• Iliac wing fracture
• Sacral fracture

Question 3

What is an unstable pelvic fracture?

Answer 3

• At least 2 fractures through pelvic ring

Question 4

What can often be included in an unstable pelvic fracture?

Answer 4

• Dislocated joint

Question 5

What are pelvic fractures life threatening?

Answer 5

• Cause major hemorrhage

Question 6

How are unstable pelvic fractures treated?

Answer 6

• Internal or external fixation

Question 7

What are the 2 types of proximal femur fractures?

Answer 7

Intra or extra capsular

Question 8

Which type of proximal femur fracture has a higher incidence of complications? Why?

Answer 8

Intracapsular due to involvement of circumflex femoral artery

Question 9

What are the 3 complications from an intra-capsular fracture of the proximal femur?

Answer 9

• AVN
• Delayed union
• Non-union

Question 10

What are 5 hallmarks of degenerative joint disease of the hip?

Answer 10

• Joint space narrowing
• Sclerotic subchondral bone
• Osteophyte formation
• Cysts or psyedocysts in subchondral bone
• Superior migration of humeral head

Question 11

What are the 5 radiographic findings of RA of the hip?

Answer 11

• Periarticular osteoporosis
• Symmetric concentric joint space noarrowing
• Synovial cysts in periarticular bone
• Axial migration of femoral head
• Acetabular protrusion

Question 12

What is an early radiographic sign of AVN of the hip?

Answer 12

Cresent signq

Question 13

What 3 things may cause AVN of the femur by means of a disruption of blood supply?

Answer 13

• Trauma
• Infection
• Prolonged steroid use

Question 14

What 3 things may cause AVN of the femur by means of thickening of vessel walls?

Answer 14

• Radiation therapy
• Lupus
• Giant cell arthritis

Question 15

What 3 things may cause AVN of the femur by means of a thromboembolism?

Answer 15

• Alcoholism
• Diabetes
• Sickle cell disease

Question 16

What is the most common hip disorder of adolescence?

Answer 16

• Slipped capital femoral epiphysis

Question 17

What does capital femoral epiphysis typically coincide with?

Answer 17

• Growth spurts

Question 18

In whom is DDH of the hip typically found?

Answer 18

• At birth or in young children

Question 19

By what 4 lines is DDH of the hip assessed?

Answer 19

• Hilgenreiners line: Horizontal through junctions of iliac, ischial, and pubic bones
• Perkin’s line: Perpendicular through outer edge of acetabulum
• Along inner and outer edges of acetabulum
• Shenton’s line of a smooth curve along the inferior border of the femoral neck connecting the inferior border of the superior pubic ramus

Question 20

In which quadrant should the early femoral head be located?

Answer 20

Lower, inner quadrant (Hligenreiner’s line should pass through the femoral shaft)

Question 21

What angle should the acetabular depth line and Perkin’s line make?

Answer 21

Less than 30 degrees

Question 22

What is the major difference in positioning of the bone between OA and RA?

Answer 22

Femur migrates superiorly in OA, and axially in RA