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Management of Hip Dislocations

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Management of Hip Dislocations

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Management of Hip Dislocations ,[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object]
Anatomy ,[object Object],[object Object],[object Object],[object Object]
Joint Contact Area ,[object Object],[object Object],[object Object]
Acetabular Labrum ,[object Object],[object Object],[object Object]
Hip Joint Capsule ,[object Object],[object Object],[object Object],[object Object],[object Object]
The ligaments of hip joint ,[object Object]
Blood Supply to Femoral Head (3 sources) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sciatic Nerve ,[object Object],[object Object],[object Object],[object Object]
Hip Dislocation: Mechanism of Injury ,[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object]
Thomas and Epstein Classification of Hip Dislocations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Limb position ? according to types
Posterior Dislocation ,[object Object],[object Object]
Types of Posterior Dislocation ,[object Object],[object Object],[object Object]
Mechanism of Anterior Dislocation ,[object Object],[object Object],[object Object]
Types of anterior dislocation ,[object Object],[object Object],[object Object]
Effect of Dislocation on Femoral Head Circulation ,[object Object],[object Object],[object Object],[object Object]
Associated Injuries ,[object Object],[object Object],[object Object],[object Object]
Cont…… ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cont… ,[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Physical Examination: Classical Appearance ,[object Object]
Physical Examination: Classical Appearance ,[object Object],[object Object],[object Object]
Irregular presentation/appearance if: ,[object Object],[object Object],[object Object]
Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object]
Radiographs: AP Pelvis X-Ray ,[object Object],[object Object],[object Object],[object Object],[object Object]
Reasons to Obtain More X-Rays Before Hip Reduction ,[object Object],[object Object]
X-rays after Hip Reduction : ,[object Object],[object Object],[object Object]
CT Scan ,[object Object],[object Object],[object Object],[object Object],[object Object]
MRI Scan ,[object Object],[object Object]
Clinical Management: Emergent Treatment ,[object Object],[object Object]
Benefits of early Reduction ,[object Object],[object Object],[object Object],[object Object]
Patterns Treated Non operatively ,[object Object],[object Object],[object Object],[object Object]
Anesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Reduction Maneuvers ,[object Object],[object Object],[object Object],[object Object],[object Object]
Allis Maneuver ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Reduction of posterior dislocation Bigelow maneuver East Baltimore lift technique
How to know reduced Hip ? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Stability Test ,[object Object],[object Object],[object Object],[object Object]
Nonoperative Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Irreducible Hip ? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Irreducible dislocation ,[object Object],[object Object],[object Object],[object Object]
Indications for open Reduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Irreducible anterior hip dislocation ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Irreducible Hip Dislocation: Posterior
1. Irreducible Posterior Dislocation with Large Femoral Head Fracture ,[object Object],[object Object]
Three Options ,[object Object],[object Object],[object Object],[object Object]
2. Hip Dislocation with Femoral Neck Fracture ,[object Object],[object Object],[object Object]
Cont….. ,[object Object],[object Object],[object Object]
3. Incarcerated Fragment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
4. Incongruent Reduction ,[object Object],[object Object],[object Object],[object Object]
5. Unstable Hip after Reduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results of Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of Hip Dislocation ,[object Object],[object Object],[object Object]
2- Post-traumatic Osteoarthritis ,[object Object],[object Object],[object Object],[object Object]
3- Recurrent Dislocation ,[object Object],[object Object],[object Object]
Recurrent Dislocation Caused by Defect in Posterior Wall and/or Femoral Head ,[object Object],[object Object],[object Object]
4- Delayed Diagnosis of Hip Dislocation ,[object Object],[object Object],[object Object],[object Object]
5- Sciatic Nerve Injury ,[object Object],[object Object],[object Object],[object Object]
Sciatic Nerve Palsy: If No Improvement after 3–4 Weeks ,[object Object],[object Object]
6- Foot Drop ,[object Object],[object Object],[object Object]
7- Infection ,[object Object],[object Object]
8- Iatrogenic Sciatic Nerve Injury ,[object Object],[object Object]
Iatrogenic Sciatic Nerve Injury ,[object Object],[object Object],[object Object],[object Object],[object Object]
10- Thromboembolism ,[object Object],[object Object],[object Object],[object Object],[object Object]
11. Heterotrophic ossification ,[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object]
Cont….. ,[object Object],[object Object],[object Object]
Thank you

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Management of Hip Dislocations

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  • 38. Reduction of posterior dislocation Bigelow maneuver East Baltimore lift technique
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