Hip Conditions Flashcards
what usually causes a hip dislocation
RTA or contact sports with the hip flexed
most common direction of hip dislocation
posterior
associated fractures with a hip dislocation
posterior acetabular wall, femoral fracture
clinical presentation of a hip dislocation
flexed, internally rotated and adducted knee
management of hip dislocation
urgent reduction and stabilisation
complications of a hip dislocation
sciatic nerve palsy
AVN femoral head
secondary OA of the hip
what is the typical mechanism of injury of a hip fracture
low impact fall in the elderly
what is hip fracture often associated with
osteoporosis
risk factors of hip fractures
osteoporosis
smoking, excess alcohol
malnutrition
low BMI
how are hip fractures classified
intracapsular or extracapsular
where do intracapsular hip fractures occur
proximal to the intertrochanteric line
how do we divide intracapsular hip fractures
subcapital or transcervical
what are intracapsular hip fractures prone to
femoral head AVN, non-union
how do we classify intracapsular fractures
garden classification
where do extracapsular hip fractures occur
distal to the intertrochanteric line
how can we divide extracapsular hip fractures
basicervical
intertrochanteric
reverse oblique
subtrochanteric
symptoms of a hip fracture
hip/groin pain
unable to weight bear
+/- swelling
clinical sign of a hip fracture
lower limb on affected side may be shortened and externally rotated
main investigation for a hip fracture
x-ray pelvis and lateral hip
sign on x-ray of a broken hip
loss of contour of shenton’s line
analgesia used in hip fractures
local nerve blocks
management of an intracapsular hip fracture
hemiarthroplasty
management of a subtrochanteric fracture
IM nail
management of intertrochanteric hip fractures
DHS screw
pathophysiology of idiopathic transient osteonecrosis of the hip
local hyperaemia and impaired venous return with marrow oedema and increased intramedullary pressure
which 2 groups may present with idiopathic transient osteonecrosis of the hip
middle age men, pregnant women in third trimester
clinical presentation of idiopathic transient osteonecrosis of the hip
- Progressive groin pain over several weeks
- Difficulty weight bearing
- Usually unilateral
gold standard investigation of idiopathic transient osteonecrosis of the hip
MRI
bloods in idiopathic transient osteonecrosis of the hip
elevated inflammatory markers
management of idiopathic transient osteonecrosis of the hip
usually resolves in 6-9 months
analgesia + crutches
what is trochanteric bursitis
inflammation of a bursa over the greater trochanter on the outer hip
who usually presents with trochanteric bursitis
young female runners
what may trochanteric bursitis be linked to
gluteal cuff syndrome
main symptom of trochanteric bursitis
pain on the lateral aspect of the hip
clinical signs of trochanteric bursitis
- Pain on palpation of the greater trochanter
- Pain on restricted abduction
what is used to diagnose trochanteric bursitis
clinical diagnosis
management of trochanteric bursitis
NSAIDs, physio, steroid injection
