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1. Dr (Major) Parthasarathy S
Junior Resident,MS Orthopaedics
Stanley Medical College,Chennai
Ref : Campbell’s operative orthopaedics 13th
edn
Rockwood and Green’s fractures in adults 8th
edition

3.  Complex
 High energy trauma
 Emergency if
 Open
 Irreducible hip dislocation associated
 Vascular compromise
 Goal of treatment - Anatomic restoration of
the dome with concentric reduction of
femoral head beneath

7.  Incomplete hemispherical socket
 Inverted horshoe shape articular surface
 Nonarticular cotyloid fosaa
 Inverted Y shaped columns
 Dome/roof-weight bearing portion

8.  Ant column
 Ant half of the iliac crest
 Iliac spines
 Ant half of acetabulum
 Pubis
 Post column
 Ischium
 Ischial spine
 Post half of acetbulum
 Dense bone forming schiatic notch

14.  X ray pelvis AP view
 Medial roof arc
 Judet views
 45 degree Iliac oblique view-affected side touching
cassette
Shows Ant wall & post column
Post roof arc
 45 degree obturator oblique view-affected side away
from cassette
Shows post wall & ant column
Ant roof arc

20.  Invaluable
 Thin cut(3mm)

22.  Letournal & Judet
 Simple types
 Ant wall
 Ant column
 Post wall (most common)
 Post column
 Transverse
 Associated types
 T type
 Post column + wall
 Transverse + post wall
 Ant column + post hemitransverse
 Both column

26.  Nonoperative treatment indication
 <2mm diplacement involving weight bearing
dome
 >25 degree ant,>45 degree medial,>70 degree
post roof arc
 <50% of post wall involvement
 Secondary congruence in displaced both column
#
 Medical contraindications
 Local soft tissue problems
 Osteoporotic bone

28.  >2mm displacement
 <45 degrees roof arc
 >50% post wall involved
 Subluxation of hip on fluoroscopic examination under
anasthesia even if <50% involved
 Incarcerated fragments in between the
acetabulum & articular femoral head surface
 Prevention of nonunion & retention of bone
stock for later reconstructive surgery

32.  Emergency if
 Open
 Irreducible hip dislocation associated
 Vascular compromise
 Progressive schiatic nerve deficit
 Ipsilateral femoral neck fracture
 Ideal within 5-7 days

48.  Older patients
 Intraarticular comminution
 Full thickness loss of cartilage
 Femoral head impaction
 Acetabular dome impaction
 Femoral neck #
 Preexistent arthritis

52.  Mortality rate 0-2.5%
 Post traumatic arthritis
 Both column & transverse post wall
 Osteonecrosis
 Post dislocation
 Infection 1-5%
 DVT 8-61%
 LMWH daily stop( 24 hrs before surgery)
 Post surgery continue for 6-12weeks
 Aspirin 325mg BD until adequately mobilised

53.  Schiatic nerve palsy 10-15%(peroneal
component common)
 Post surgery 2-6%

56.  Heterotrophic ossification
 Indomethacin 25mg TID for 3-6 weeks
 Celecoxib 200mg OD for 6 weeks
 One time 700cGy radiation in whom NSAID is
contraindicated
 Debride devitalised muscle

57.  Class 1 is described as islands of bone within
the soft tissues about the hip
 Class 2 includes bone spurs originating from
the pelvis or proximal end of the femur,
leaving at least 1 cm between opposing bone
surfaces
 Class 3 consists of bone spurs originating
from the pelvis or proximal end of the femur,
reducing the space between opposing bone
surfaces to less than 1 cm
 Class 4 shows apparent bone ankylosis of the
hip