The hip

Question 1

blood supply to the head and neck of femur

Answer 1

superior - branch of the obturator artery

inferior - lateral femoral circumflex artery and medial circumflex artery

Question 2

NOF

Answer 2

intracapsular - proximal to intratrochanteric line

extracapsular - distal to intratrochanteric line

Question 3

trendelenbergs sign

Answer 3

shows weakness n the gluteus medius on the leg standing on the floor

Question 4

common hip problems

Answer 4

childhood: developmental dysplasia of the hip (DDH) (0-3yrs); Pethes disease (4-8yrs); slipped upper femoral epiphysis (SUFE)(10-15+yrs)
adult: arthrits

Question 5

perthes disease

Answer 5

temporary disruption to the blood flow to the head of the femur. this can lead to avascular necrosis

Question 6

DDH

Answer 6

incindence - 1-2/1000
risk factors:
girls:boys 7:1
FH
breech
post natal position

Question 7

tests for DDH

Answer 7

done during 6 week check
Galeazzi’s sign
Barlo’s test
Ortolani’s test

Question 8

Tx for DDH

Answer 8

harness maintaining hips in congruent reduction will allow normal hip development. late presentation will require surgical repair

Question 9

Perthes

Answer 9

age 4-8years
incidence 1/10,000
boys:girls 4:1
pain, limp, limited ROM
unknown cause
transient AVN of femoral epiphysis
revascularisation
repair
remodelling

Question 10

Tx of perthes

Answer 10

pain relief
maintian ROM
containment of the head of the femur
maintain shape
surgery

Question 11

SUFE

Answer 11

during pubertal growth spurt
boys 12-16, girls 10-15
hormonal imbalance (GH>sex) - fat, hypogonadal; tall, thin; hypothyroid
trauma
acute or acute-on-chronic
bilateral ~30%

Question 12

Tx of SUFE

Answer 12

surgery to pin head of femur back into correct position