This document discusses hip dislocation, including anatomy, mechanisms of injury, classification, clinical evaluation, treatment, and complications. It notes that hip dislocations are usually caused by high-energy trauma and result in the femoral head being displaced from the acetabulum. Posterior dislocations are more common, occurring when the flexed knee strikes an object. Treatment involves closed or open reduction to place the femoral head back in the acetabulum, sometimes requiring surgical reconstruction for fractures. Complications can include osteonecrosis, osteoarthritis, nerve injuries, and recurrent dislocations.
Avascular necrosis (AVN) of the femoral head is a pathologic process that results from interruption of blood supply to the bone. AVN of the hip is poorly understood, but this process is the final common pathway of traumatic or nontraumatic factors that compromise the already precarious circulation of the femoral head. Femoral head ischemia results in the death of marrow and osteocytes and usually results in the collapse of the necrotic segment
ANKLE FRACTURES
Pott’s fracture
A Pott’s fracture is a type of ankle fracture that is characterized by a break in one or more bony prominences on the sides of the ankle known as the malleoli.
Also known as Broken Ankle, Ankle Fracture and malleolar fracture.
Pott’s fracture often occurs in combination with other injuries such as a sprained ankle or other fractures of the foot, ankle or lower leg.
Avascular necrosis (AVN) of the femoral head is a pathologic process that results from interruption of blood supply to the bone. AVN of the hip is poorly understood, but this process is the final common pathway of traumatic or nontraumatic factors that compromise the already precarious circulation of the femoral head. Femoral head ischemia results in the death of marrow and osteocytes and usually results in the collapse of the necrotic segment
ANKLE FRACTURES
Pott’s fracture
A Pott’s fracture is a type of ankle fracture that is characterized by a break in one or more bony prominences on the sides of the ankle known as the malleoli.
Also known as Broken Ankle, Ankle Fracture and malleolar fracture.
Pott’s fracture often occurs in combination with other injuries such as a sprained ankle or other fractures of the foot, ankle or lower leg.
JOINT DISLOCATION of hip knee and shoulder PART-2.pptxrammmramm000
JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip kn
With the pandemic overclouding the whole world it has effected every strato of people including the Orthopaedic groups. This is to highlight the impact of COVID 19 on the orthopaedic in general.
Conservative management in 3 and 4 part proximal humerus fractureBipulBorthakur
Proximal humerus fracture is common in both young as well as elderly people with most of the elderly patients unable to undergo operative management. This study is to see the aspect of conservative management in proximal humerus fracture.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. ANATOMY
• Hip joint is a Ball and Socket type joint- Stability:-
-Anatomical configeration
-Capsule
-Ligaments
• 40 % of the femoral head in any position.
• But in Flexion,Adduction, Internal rotation is a vulnerable position
• The hip joint capsule is anteriorly attatched to intertrochanteric line and posteriorly it’s
1/2inch short.
3. LIGAMENTS AROUND HIP JOINT
• Inverted Y or Bigelow ligament- Strong ligament- Anteriorly
• Ischiofemoral ligament- posteriorly
• Iliofemoral ligament posteriorly
6. ANATOMY
• The main vascular supply to the femoral head is from Ascending branches of the medial
and lateral femoral circumflex arteries, branches of profunda femoral artery , which
arises from Femoral artery.
• An extra-capsular vascular ring is formed at the base of the femoral neck, it contributes
retinacular vessels which pierces the neck to supply blood to femoral head.
• The artery of the ligamentum teres, a brunch of the obturator artery, also contribute
blood supply from medial side.
7.
8. MECHANISM OF INJURY
• Hip dislocation almost always results from high energy trauma, such as
– motor vehicle accidents,
– fall from height, or
– an industrial accident
– Posterior hip dislocations are much more common - 85-90%
THE FORCES COULD ARISE FROM;
1.The anterior part of flexed knee striking against an object
2.From the sole of feet with ipsilateral knee extended
3.From the greater trochanter
4.Rarely from posterior pelvis
9. CLASSIFICATION
• Posterior
- Epstein classification, Pipkin’s classification
• Anterior
- Obturator type , Ileal type
• Central- Nowadays discussed with acetabular fracture
10. POSTERIOR DISLOCATION
• These comprise 85 90 % of traumatic dislocation of the hip
• They results from trauma to the flexed knee, commonly in a seated car(eg:
dashboard injury) , the femur is thrust proximally and the femoral head is
forced posteriorly, often a piece of bone from acetabulum is sheared off.
• Thompson and Epstein Classification :
• Type I : Dislocation with no more than minor chip fractures
• Type II: Dislocation with single large fragment of posterior acetabular wall
• Type III: Dislocation with comminuted fragments of posterior acetabular wall
• Type IV: Dislocation with fracture through acetabular floor
• Type V: Disloction with fracture through acetabular floor and femoral head
15. ANTERIOR DISLOCATION
• These injuries results from external Rotation and Abduction of hip
• Epstein Classification:
• Type I : Superior dislocation, including pubic and subspinous
– Type IA: No associated fractures
– Type IB: Associated fracture or impaction of the femoral head
– Type IC: Associated fracture of the acetabulum
• Type II: Inferior dislocation, including obturator, and perineal
– Type IIA:No associated fractures
– Type IIB: Associated fracture or impaction of the femoral head
– Type IIC: Associated fracture of the acetabulum
16.
17.
18. CENTRAL FRACTURE – DISLOCATION
• Femoral head is driven through the medial wall of acetabulum toward the pelvic
cavity .
• The displacement of the head varied from the minimal to as much as the whole head
lying inside the pelvis.
• For this, skeletal traction is applied distally and laterally.
19.
20.
21. CLINICAL EVALUATION
• A full trauma survey is essential because of the high energy nature of these injuries.
• The classic appearance of an individual with a posterior hip dislocation is a patient in
severe pain with the hip in position of Flexion, internal rotation, and adduction.
• Patients with an anterior dislocation hold the hip in marked external rotation with mild
flexion and Abduction
• A careful neuro vascular examination is essential because injury to the sciatic nerve or
femoral neurovascular structures may occur at the time of dislocation
22. RADIOGRAPHIC EVALUATION
• An Anteroposterior (AP) radiograph of the pelvis is essential, as well as a cross table
lateral view of affected hip
• On AP view :
• In posteior dislocation, the affected femoral head will appear smaller than the normal
femoral head
• In anterior dislocation, the femoral head will appear slightly larger
• The shenton line should be smooth and continuous
• The realtive appearance of the greater and lesser trochanters may indicate pathological
internal or external rotation of the hip
23. RADIOGRAPHIC EVALUATION
• Use of 45 degree oblique views of the hip may be helpful to ascertain the presence of
osteochondral fragments, the integrity of the acetabulum, and the congruence of the
joint spaces
• CT scan should be obtained to detect the presence of intra articular fragments and to
rule out associated femoral head and acetabular fractures
24. TREATMENT
• Dislocation should be reduced on an urgent basis, to minimize the risk
of osteonecrosis of the femoral head
• Long term prognosis worsens if reduction is delayed more than 12
hours.
• Associated acetabular or femoral head fracture can be treated in the
subacute phase.
• Close reduction : Under sedation/Anaesthesia
• Techniques are-Allis, Stimpson and bigelow’s etc
• Supine, Prone, Lateral
25. TREATMENT
• 1.Allis Method:
• Patient is place supine with the surgeon standing above the patient on table.
• Initially, the surgeon applied in line traction while assistant applies countertraction
by stabilizing the patient’s pelvis.
• While increasing the traction force, the surgeon should slowly increase the degree
of Flexion to approximately 70 degree.
• Gentle rotational motion of the hip as well as slight adduction will often help the
femoral head to clear the hip of the acetabulum.
• A lateral force to the proximal thigh may assist in reduction.
• An audible “clunk” is a sign of a successful closed reduction
26.
27. TREATMENT
• 2. Stimson Gravity Technique:
• The patient is placed prone on table with affected leg hanging off
the side of the table.
• In this position, the assistant immobilizes the pelvis, and the
surgeon applies an anterior directed, force on the proximal calf.
• Gentle rotation of the limb may assist in reduction
28.
29. TREATMENT
• 3. Bigelow and Reverse Bigelow Maneuvers :
• The patient is in supine, and the surgeon applies longitudinal traction on the
limb,
• The adduction and internally rotated thigh is then flexed at least 90 degrees
• The femoral head is then levered into the acetabulum by abduction, external
rotation, and extension of the hip.
• In Reverse Bigelow Maneuvers, used for anterior dislocation, traction is again
applied in the line of deformity. The hip is then adducted, sharply internally
rotated and extended.
30.
31. IMMOBILIZATION AFTER REDUCTION
• Post reduction CT scan is more important than pre-reduction to
confirm congruous reduction.
• Immobilization depends upon CT picture showing Acetabular or
Femoral injury
• Depends upon degree of injury
• MRI is important for Knee joint ligamental injuries in comparison to
Hip joint.
32. TREATMENT
• IF CLOSED REDUCTION SUCCESSFUL, DO STABILITY TEST(TELESCOPIC
TEST) AND THEN MAINTAIN REDUCTION WITH SPLINT.
• IF REDUCTION NOT POSSIBLE;
Causes;
- Infolding of Labrum- Button holdindg by capsule
and short rotators
-Sciatic nerve
-Bony fragments
33. TREATMENT –IF CLOSED REDUCTION FAILS
• Open reduction :
• Has to be done immediately
• Reconstuction of acetabulum is delayed
RECONSTRUCTION
• Reconstruction of Hip
• Reconstruction of acetabulum
Usually done in 2nd week following trauma
34. TREATMENT :Open reduction
• Approaches:
• Kocher-Langenbeck approach
– Posterior approach
– Done for the exploration of sciatic nerve, treatment of major posterior labral disruptionor
instability, and of Posterior acetabular fractures
• Smith- Peterson Approach
– Anterior approach
– Done for isolated femoral head fracture
• Watson-Jones approach
– Anterolateral approach
– Useful for most anterior dislocation and combined fracture of both femoral head and neck
35. PROGNOSIS
• 70-80 % good or excellent outcome in posterior dislocation.
• Anterior dislocation of hip are noted to have a higher incidence
of associated femoral head injuries .
36. COMPLICATIONS• Osteonecrosis (AVN)
– Seen in 5-40 % of injuries
– Increased risk associated with increased time untill reduction (>6-24 hours)
– Osteonecrosis may become clinically apparent several years after injury
• Post traumatic Osteoarthritis
– Most frequent long term complication.
– Incidence is more when associated with acetabular fractures or transchondral
fracture of femoral head
• Recurrent dislocation
• Neurovascular injury
– Sciatic nerve injury occurs in 10-20 % of hip dislocation
• Femoral head fracture
• Heterotopic ossification
37. In case of any suggestions/Questions
kindly message/contact on
Mob: +919435031719
Email: drbipulborthakur@gmail.com
drbborthakur@rediffmail.com
THANK YOU..