The Hip

Question 1

What type joint?

Answer 1

Ball and socket

Question 2

What gives this unstable joint some stability? (2)

Answer 2

Labrum

Joint capsule

Question 3

Blood supply to the femoral head? and where do these arise from? (4)

Answer 3

Medial and lateral femoral circumflex

Medial dominates and gives rise to reticular vessels which run underneath the capsule.

Profunda femoris

Question 4

Hip # classification system

Answer 4

Garden classification - how displaced is it? - Makes decision on how to Rx.

Question 5

Who would you give a hemiarthroplasty?

Answer 5

Intracapsular #’s with a high probability of disruption to blood supply

If young and intracapsular, with relatively little displacement then consider internal fixation (DHS)

Question 6

Who would you offer internal fixation (dynamic hip screw)?

Answer 6

Extracapsular #’s with a low probability of disruption to blood flow.

Question 7

Typical hip dislocation mechanism?

Answer 7

Axial load on femur whilst the leg is flexed and adducted.

Question 8

Which nerve is injured in hip dislocation?

Answer 8

Sciatic nerve - 20% of cases present with foot drop.

Question 9

Main features of osteoarthritis on an X-ray?

Answer 9

LOSS
Loss of joint space 
Osteophytes 
Subarticular sclerosis 
Subchondral cysts