← All decks
The first 25 slides, exactly as they appear. The full deck has 67 content slides.
Orthopaedics
Hip Dislocations and Femoral Head Fractures
Built from Tang — Orthopaedic Trauma Vol 2: Lower Extremity
What’s inside
3 sections · 67 slides
Overview
- What this topic covers
Basic Theory and Concepts
Anatomy, mechanism, classification, and assessment
- How common are these injuries?
- Overview: why femoral head fractures are dangerous
- Anatomy 1: the bony parts that hold the hip in place
- Bony anatomy of the acetabulum and femoral head
- Anatomy 2: the labrum and the three capsular ligaments
- Capsular ligaments of the hip
- Why a flexed hip dislocates so easily
- Anatomy 3: muscles are active stabilizers
- Muscle force vectors around the hip
- Anatomy 4: how weight is carried through the head
- Weight-bearing zone and axis mismatch of cup and head
- The forces the hip must survive
- Anatomy 5: the blood supply that can be lost
- Arterial blood supply to the femoral head and neck
- Mechanism: body position decides the injury
- Force direction and dislocation pattern
- Classification 1: Thompson-Epstein (the dislocation)
- Classification 2: the Pipkin types
- Pipkin classification of femoral head fractures
- Clinical assessment: read the limb, then the whole body
- Dislocation with head fracture: pre- and post-reduction
- Imaging 1: the X-ray and its reference lines
- Imaging 2: Judet oblique views for the acetabulum
- Judet oblique views of the acetabulum
- Imaging 3: CT is the decisive test
- CT of a femoral head fracture
- 3D CT: head fracture with a subtrochanteric fracture
Surgical Treatment
Reduction techniques, approaches, fixation, and complications
- Step 1: closed reduction — put it back, urgently
- Reducing a POSTERIOR dislocation
- Reduction maneuvers for posterior hip dislocation
- Reducing an ANTERIOR dislocation
- Reduction maneuvers for anterior hip dislocation
- After reduction: confirm and decide
- Anterior dislocation treated by closed reduction
- Small posterior wall fragment: conservative care
- Step 2: when surgery is indicated
- The four goals of surgery
- Comminuted head-neck fracture: arthroplasty
- Choosing the surgical approach
- Matching approach to Pipkin type
- Smith-Petersen ORIF: setup and exposure
- Smith-Petersen approach: position and incision
- Smith-Petersen approach: superficial dissection
- Smith-Petersen approach: deep dissection
- Smith-Petersen ORIF: reducing and fixing the fragments
- Choosing the internal fixation
- Cannulated-screw fixation of the head
- Absorbable-screw fixation of an anterior head fragment
- Absorbable-screw case: postoperative reconstruction
- Kocher-Langenbeck ORIF: setup and exposure
- Kocher-Langenbeck approach: position and incision
- Kocher-Langenbeck approach: layered dissection
- Kocher-Langenbeck ORIF: fixation and closure
- K-L fixation: head and posterior wall
- Complications 1: avascular necrosis (the head dies)
- Complications 2: heterotopic ossification
- Key takeaways
- Why must a dislocated hip be reduced as an emergency?
- References (1/4)
- References (2/4)
- References (3/4)
- References (4/4)
- Orthopaedic Trauma Surgery - Volume 2: Lower Extremity