Lecture 2: The Pelvis and Hip Joint

Question 1

What kind of joint is the hip joint?

Answer 1

Ball and socket synovial joint

Question 2

What structures confer stability upon the hip joint?

Answer 2

Acetabular anatomy
Fibrous capsule
Ligaments :	
   - Ileofemoral
   - Pubofemoral
   - Ischiofemoral

Question 3

What features of acetabular anatomy stabilise the hip joint?

Answer 3

• The articular surface is smooth and crescent shaped – ‘lunate surface’
• It is deficient inferiorly - acetabular notch
• The acetabular notch is bridged by the transverse acetabular ligament
• Acetabular labrum
  
  • a rim / lip of cartilage
  • deepens the articular surface

Question 4

What are the attachments of the fibrous capsule?

Answer 4

Proximal attachment encircles rim of acetabulum

Distal attachment is to the femoral neck
intertrochanteric line and greater trochanter

Question 5

How do the pelvic ligaments contribute to stability?

Answer 5

• Spiral around the hip joint
• Taut when hip is extended
• Pull the femoral head into the acetabulum
• Improves stability

Question 6

What function does the iliofemoral ligament perform?

Answer 6

• Covers hip joint superiorly and anteriorly
• Strongest ligament
• Prevents hyperextension of the hip during standing - ‘screws in’ the femoral head

Question 7

What function does the pubofemoral ligament perform?

Answer 7

• Covers hip joint inferiorly and anteriorly

- Prevents excessive abduction

Question 8

What function does the ischiofemoral ligament perform?

Answer 8

• Covers hip joint posteriorly

- Weakest ligament

Question 9

What kind of force would cause an inferior and superior pubic rami fracture?

Answer 9

Lateral force - elderly person falling

Question 10

What kind of force would cause an ‘open book’ fracture of the pelvis?

Answer 10

Large force directly from the front e.g. someone being thrown off a motorbike and hitting a wall.

Question 11

What sort of force can cause a posterior dislocation?

Answer 11

Impact when hip is

• flexed
• internally rotated
• adducted