Hips! part 1, Palmer Flashcards
What tissues are likely to be injured in a patient with hip luxation?
- Joint capsule
- Ligament of head of femur (round ligament)
- Surrounding mm - varying degree
- Joint Cartilage - more abrasion with time
others. …
5. avulsion fracture of femoral head?
6. Chip fracture of acetabular rim?
- sciatic n injury?
- GT fracture
What direction is the hip most likely to displace?
Cranio-dorsal is the most common
others…
Caudo-dorsal
Caudo-ventral
What should we look for in Caudodorsal luxation?
Sciatic nerve injury and fracture of GT!
_____ rotation of hip is common with craniodorsal luxations
External rotation
What rad views should be taken?
Chest! think of trauma
V/D and Lateral views of pelvis
What are we looking for on rad views of pelvis?
- hip conformation
- avulsion and chip fractures
- Confirm direction of luxation
A patient presents with a recent luxation (< 5 days), good hip conformation, no femoral head avulsion fx’s, no acetabular rim chip fractures,. What tx would you perform?
Closed reduction
Warn O, 50% chance of reluxation
Yay, you did a closed reduction! Now what?
- Dorsal luxation
- Ventral luxation
- ALL hip luxations
- Dorsal: Ehmer sling x2 wks (maintains abduction and internal rotation), needs to be checked daily (tape)!
- Ventral: Hobbles x2 wks (prevents abduction of limbs)
- No running, jumping, stairs, climbing on furniture or slippery surfaces for 4-6 wks
After closed reduction… it won’t stay reduced! Now what?
- Open (sx) reduction and stabilization
- FHNE - salvage procedure
- THR
Name 5 Sx Stabilization Methods
- Capsulorrhaphy - sutures in joint capsule
- Capsular Augmentation
- Toggle Pin - prostatic round lig
- Elastic External Fixator - provides abduction and internal rotation
- Trochanter Transposition - provides abduction and internal rotation
What is Legg Calve Perthes Disease?
Non-inflammatory, aseptic necrosis of the femoral head prior to closure of capital femoral physis
Simply put, “Aseptic necrosis of the femoral head”
Legg Calve Perthes is an _____ recessive gene
autosomal recessive
What is the typical signalment of patient with Legg Calves Perthes Dz?
Toy and terrier breeds, young (3-13 mos), equal M and F
What do you see in early dz process in LCP? Late?
Early: “apple-core” bone loss in neck, +/- radiolucencies in femoral head
Late: collapse of femoral head, +/- avulsion fracture of epiphysis
How can LCP Dz be treated? Prognosis?
FHNE
Prognosis very good with FHNE (toy breeds)
Slight lameness may remain due to limb shortening
Slight thigh atrophy may remain
