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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