Short Case 25 -Management of Hip Dislocation with ipsilateral shaft of femur fracture
Management
of Hip Dislocation with ipsilateral shaft of femur fracture
Anterior Dislcation
|
Posterior Dislocation
|
MOI- Abducted , Hip and knee flexed
|
Adducted
|
Lengthening
|
Shortening , Flexed adducted and IR
|
Type
Superior – towards symphysis pubis
Inferior – towards obturator foramen
|
No subtypes
|
Head Large
|
small
|
Hip
Dislocation + SOF Fracture
Difficult
with CR
1. Open
reduction is an option .
Kuntcher
Nail
Fracture
at Isthmus level ,
Transverse
configuration
Damage
control surgery
2. Hip
relocate
Fracute
management
IM
Fixation – best for long bone fracture
Closed
reduction attempt otherwise open relocation .
How
to critically analyse X-rays ?
Anatomic
location of bone
Bone
density
Rod
Length
Alignment
Proximal
screw
Nail
Nail
in femur
Anterolateral
bowing
Tibia
Nail has Herzog’s angle – 11 degrees
This
angle to negotiate with bone contour.
Note
Hoop
stress – during reaming or putting nail , tangential force to lateral cortex.
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