What is a stable pelvic fracture?
At most one fracture through the pelvic ring.
What are 3 types of stable pelvic fractures?
- Avulsions
- Iliac wing fracture
- Sacral fracture
What is an unstable pelvic fracture?
- At least 2 fractures through pelvic ring
What can often be included in an unstable pelvic fracture?
- Dislocated joint
What are pelvic fractures life threatening?
- Cause major hemorrhage
How are unstable pelvic fractures treated?
- Internal or external fixation
What are the 2 types of proximal femur fractures?
Intra or extra capsular
Which type of proximal femur fracture has a higher incidence of complications? Why?
Intracapsular due to involvement of circumflex femoral artery
What are the 3 complications from an intra-capsular fracture of the proximal femur?
- AVN
- Delayed union
- Non-union
What are 5 hallmarks of degenerative joint disease of the hip?
- Joint space narrowing
- Sclerotic subchondral bone
- Osteophyte formation
- Cysts or psyedocysts in subchondral bone
- Superior migration of humeral head
What are the 5 radiographic findings of RA of the hip?
- Periarticular osteoporosis
- Symmetric concentric joint space noarrowing
- Synovial cysts in periarticular bone
- Axial migration of femoral head
- Acetabular protrusion
What is an early radiographic sign of AVN of the hip?
Cresent signq
What 3 things may cause AVN of the femur by means of a disruption of blood supply?
- Trauma
- Infection
- Prolonged steroid use
What 3 things may cause AVN of the femur by means of thickening of vessel walls?
- Radiation therapy
- Lupus
- Giant cell arthritis
What 3 things may cause AVN of the femur by means of a thromboembolism?
- Alcoholism
- Diabetes
- Sickle cell disease
What is the most common hip disorder of adolescence?
- Slipped capital femoral epiphysis
What does capital femoral epiphysis typically coincide with?
- Growth spurts
In whom is DDH of the hip typically found?
- At birth or in young children
By what 4 lines is DDH of the hip assessed?
- Hilgenreiners line: Horizontal through junctions of iliac, ischial, and pubic bones
- Perkin’s line: Perpendicular through outer edge of acetabulum
- Along inner and outer edges of acetabulum
- Shenton’s line of a smooth curve along the inferior border of the femoral neck connecting the inferior border of the superior pubic ramus
In which quadrant should the early femoral head be located?
Lower, inner quadrant (Hligenreiner’s line should pass through the femoral shaft)
What angle should the acetabular depth line and Perkin’s line make?
Less than 30 degrees
What is the major difference in positioning of the bone between OA and RA?
Femur migrates superiorly in OA, and axially in RA
