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Othro Adult Hip
Reivew of Ortho of Adult HIp
92
Medical
Professional
03/03/2012

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Cards

Term
Most of the blood supply of the femoral head is derived from the
Definition
MEDIAL and lateral femoral circumflex arteries
Term
________ is not adequate blood supply to the head of femur
Definition
artery of ligamentum teres
Term
femur neck shaft angle normal
Definition
135deg
Term
avg anteversion in adults
Definition
14deg
Term
medial femoral circumflex artery is _______ while the lateral is _________
Definition
posterior
anterior
Term
pain may present in the hip with
Definition
radicular back pathology
Term
approx what percent of the femoral head is covered by acetabulum in any given ROM
Definition
40%
Term
used to test difference in knee height caused by hip pathology
Definition
Galeazzi Test
Term
if the femoral head collapses or dislocates into the pelvis you can have a
Definition
short leg
Term
collapsed femoral head
Definition
Mushroom shaped head
Term
-no acetabulum
-head has collapsed
Definition
Dysplastic acetabulum (acetabular dysplasia)
Term
hip dislocation seen in adults who are hemiplegic
Definition
Congenital Hip Dislocation
Term
can cause leg length discrepancy
Definition
hip dislocation
Term
normal shaft neck angle
Definition
120-135deg
Term
110 deg shaft neck angle
Definition
coxa vara
Term
140 deg shaft neck angle
Definition
coxa valga
Term
-test to distinguish hip pain from back pain
-positive with pain
-abduction and external rot of hip
-cross leg on other leg
-dec ROM could indiate arthritic joint
Definition
Fabre sign
Term
AVN
Definition
osteonecrosis
Term
pain over the greater trochanter in younger athletes
Definition
Iliotibial band tendonitis
Term
loose bodies of cart floating around in the joint, could be froma hernia
Definition
Intraarticular pathology
Term
-hypertrophy of synovium
-in the knee
-dev villi just like in the intestine - hypertrophic, pigmented, red
Definition
Pigmented Villonodular Synovitis (PVNS)
Term
labrum inverts on itself causing pain
Definition
Hypermobile labrum / hip
Term
cause of hip dislocations
Definition
labral tear
Term
how to diagnose a labral tear
Definition
MRI
Arthrogram
Term
hyaline cartilage pieces tumbling around in the joint becoming smooth round and shiny and can impinge and cause dec ROM and ischemia
Definition
Loose bodies
Term
-cracks form in the articular cartilage and the underlying subchondral bone
Definition
Osteochaondritis dissicans (OCD)
Term
blood deprivation to the subchondral bone causing AVN, when bone is reabsorbed the articular cartiliage fragments forming osteochondral fragments in the jointspace
Definition
OCD
Term
Pain in the suprapatellar region, medial thigh, buttocks
Definition
referred pain from the hip
Term
children with knee pain must be checked for
Definition
hip pathology
Term
in children an epiphyseal fx of the femoral head can radiate pain thru the obturator nerve to the
Definition
Knee
Term
degenerative disease of the hip
Definition
osteoarthritis
Term
what condition may cause the pt weakness of the gluteus muscle over time and may dev a glut med type of limp (trendelenberg sign)
Definition
Osteoarthritis of the hip
Term
hard bone formation
Definition
sclerosis
Term
collapsed joint
spurs form
sclerosis
Definition
osteoarthritis
Term
femoral head protrudes into the pelvis
Definition
acetabular protrusion
Term
may injure the illiac vessels
Definition
acetabular protrusion
Term
conservative therapy for OA is based on
Definition
preservation of activity and control of pain - activity modification, assistive devices
Term
surgical tx for OA often calls for
Definition
joint replacement
Term
what drug for OA can cause Pancytopenia or a dec in all cells in the blood stream and is reserved for when all else fails
Definition
Indomethacin (NSAID)
Term
grooves in the hip prosthesis allow
Definition
bone to grow into it and hold it into place
Term
-procedure that tends to fail
-only replace head of the femur
Definition
hip resurfacing
Term
-injury that does not heal well
-fx of bone surrounding a prosthesis
Definition
Periprosthetic fx
Term
what about leg length after hip prosthesis
Definition
it is expected that you will not have the same leg length
Term
-25% chance after total hip replacement
-dx with doppler study or venogram
-need prophylaxis before total hip
Definition
DVT
Term
-1% after total hip
-prophylaxis
Definition
infection
Term
compression stockings
sequential pressure boot
coumadin (warfarin)
low molecular weight heparin
continuous passive motion (CPM)
Definition
DVT prophylaxis
Term
low molecular weight heparin tx for
Definition
bed ridden geriatric pts, once per day
Term
prosthesis is removed after an infection, a spacer is placed with cement abx - monitor pts until better, devastating for the pt
Definition
Girdle stone procedure
Term
up until the 20th century a broken hip was a death sentence due to
Definition
blood lose (2-3 units of blood)
infection
DVT
ambulation
Term
can bear weight on hip but very painful ROM
Definition
Impacted non displaced fx
Term
capital fx
subcapital fx
transcervical fx
basicervical fx
Definition
intracapsular hip fxs
Term
basicervical fx
trochanteric fx
subtrochanteric fx
Definition
extracapsular fx
Term
tells us how to tx an intracapsular fx
Definition
Garden classification
Term
-fx non displaced, not thru whole neck
-pins to hold in place, no replace
Definition
Garden I
Term
-non displaced fx thru whole neck
-replace head
-some pin it
Definition
Garden II
Term
-displaced fxs of the neck
-total hip replacement
Definition
Garden III and IV
Term
proximal part of the femur is broken off so you need a prosthesis that is a little longer and anchors lower in the femur
Definition
Calcar replacement
Term
Basicervical fx tx
Definition
non displaced - pin it
displaced - replace it
Term
two part non displaced
Definition
type I intertrochanteric
Term
two part displaced
Definition
type II intertrochanteric
Term
3 part, loss of posterior lateral support
Definition
type III intertrochanteric
Term
3 part, loss of medial support
Definition
Type IV intertrochanteric
Term
four part fx
Definition
type V intertrochanteric
Term
tx for type I intertrochanteric fx
Definition
Compression lag screw
Term
plate anchoring outside of the femur and then screw thru the plate that extended thru the neck and head of the femur
Definition
Compression lag screw
Term
tx for type I intertrochanteric fx
Definition
Troch nail
Term
insertion thru the femur, insertion thru the neck and head, anchoring screw mid shaft of the femur
Definition
Troch nail
Term
non displaced subtrochanteric fx
Definition
Grade I
Term
tx for a subtrochanteric fx Grade I
Definition
troch nail
Term
95% of hips dislocate
Definition
posteriorly
Term
anterior hip dislocation is a result of
Definition
abduction and external rot (like if you pushed the Fabre test too far)
Term
posterior hip dislocation is a result of
Definition
longitudinal force is applied in line with the femur and acting on adducted hip - DASHBOARD INJURY
Term
which breaks more femur or pelvis
Definition
pelvis
Term
flexed at hip, adducted and internally rotated
Definition
posterior dislocation
Term
externally rotated with varying degrees of flexion and abduction
Definition
anterior dislocation
Term
used for tx of a dislocated hip w/o fx
Definition
adduction brace
Term
________ reduction of hip is preferred
Definition
closed
Term
reduction of hip should be done with
Definition
complete paralysis
Term
posterior dislocaiton of the hip can cause
Definition
AVN due to injury to the medial femoral circumflex artery
Term
posterior dislocaiton of the hip can cause
Definition
sciatic nerve palsy - foot drop
Term
posterior dislocaiton of the hip can cause
Definition
OA of hip
Term
numbness in the anterior part of the leg
Definition
Meralgia Paresthetica
Term
Meralgia paresthetica
Definition
pinching of the lateral femoral cutaneous nerve
Term
inj cortisone
cut nerve
Definition
tx for meralgia paresthetica
Term
what do women with tight jeans and truck drivers have in common?
Definition
Meralgia paresthetica
Term
can cause mushroom shaped head
Definition
adult congenital dislocation of the hip
Term
-MRI
-holes and dark areas
-been there for a while
-AVN of the hip
Definition
cystic changes in the head
Term
steroids
EtOH
trauma
Caissons Disease
Radiation
Definition
AVN of hip risk
Term
the bends, divers get it, pressure changes and release of nitrogen bubbles into the bone
Definition
Caissons disease
Term
cut out the core of the femoral anatomical neck and intertrochanteric space to allow bleeding to reperfuse the area, but it severely weakens the hip
Definition
core decompression
Term
tx for AVN
Definition
core decompression
fibula vascularized stress graft
Term
core of fibular head is replaced with part of the fibula and then pedicle vessesl of the graft are anastomosed with the lateral femoral circumflex artery
Definition
fibula vascularized stress graft
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