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P- 2 - Ortho 2 > 5 - Hip (2) > Flashcards

5 - Hip (2) Flashcards

1
Q

What is FAI?

A

Femoral acetabular impingement

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2
Q

Describe femoral acetabular impingement (FAI)

A

Repetitive microtrauma from impingement of the femoral head against the acetabulum

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3
Q

What is Pincer type FAI?

A

Excess acetabular coverage

Subtle joint subluxation

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4
Q

What is Cam type FAI?

A

Aspherical part of the femoral head-neck junction interferes with movement

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5
Q

Are most cases of FAI Pincer or Cam?

A

Trick question - most cases of FAI are BOTH Pincer and Cam

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6
Q

Clinical presentation of FAI?

A

Trauma

Childhood hip disease (including dysplasia)

Slipped capital femoral epiphysis

Insidious onset

Groin pain

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7
Q

What is Legg-Calve-Perthes disease?

A

Avascular necrosis of the femoral head (insufficiency of obturator artery branch)

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8
Q

PE findings on FAI?

A

Persistent hip or groin pain

Decreased internal rotation in flexion

Trendelenburg sign

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9
Q

Radiographs of FAI?

A

Pincer-type - Figure 8 sign (anteriorly)

Cam-type - pistol grip deformity

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10
Q

Management of FAI?

A

Conservative - exercises, PT, NSAIDs - non-impact stuff (elliptical, cycle)

Surgical - femoral reshaping, debridement of labral tears, periacetabular osteotomy

THA for advanced cases

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11
Q

Tenderness of the groin and increased pain with passive abduction suggests injury to:

A

The hip adductors

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12
Q

Increased pain when the patient tries to do a sit-up suggests injury to the:

A

Abdominals

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13
Q

Increase pain with flexion of the hip against resistance or with passive extension of the hip suggests injury to the:

A

Hip flexor

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14
Q

Contusion in the quadriceps muscle may progress to:

A

Myositis ossificans

Can appear like a malignant tumor on radiograph

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15
Q

Pelvic avulsion fractures with ANY displacement requires:

A

Surgical consult

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16
Q

Describe the txt regimen for nondisplaced pelvic avulsion fx’s: (athletes)

A 
Week 1 - RICE and NSAIDs
Week 2 - PROM and PWB
Week 3 - Resistance
Week 4-6 - Dynamic Drills
Month(s) 2 - Return to play
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17
Q

Mortality for pelvic fx’s:

A

Open - 50%

Closed - 25%

18
Q

How much blood can accumulate in the setting of a pelvic fx without clinical evidence?

A

2L

19
Q

How is slipped capital femoral epiphysis described?

A

Ice cream scoop falls off the cone (based on radiograph appearance)

Chubby kids

20
Q

Pelvic fx’s include fx’s of the:

A

Pelvic ring
Sacrum
Acetabulum

21
Q

What are the two columns of the pelvis?

A

Anterior (iliopubic)

Posterior (ilioischial)

22
Q

What are the two walls of the pelvis? (Rim, lip)

A

Anterior

Posterior

23
Q

Increased alpha angle is associated with:

A

FAI

24
Q

What muscle for ischial tuberosity?

A

Hamstrings

25
Q

What muscle for pubic symphysis?

A

Adductors

26
Q

What muscle for lesser trochanter?

A

Iliopsoas

27
Q

What muscle for greater trochanter?

A

Gluteus med-min

28
Q

What muscle for anterior inferior iliac spine?

A

Rectus femoris

29
Q

What muscle for anterior superior iliac spine?

A

Sartorius

30
Q

What muscle for iliac crest?

A

Abdominal muscles

31
Q

Stable pelvis fx’s:

A

Single pubic ramus

Unilateral pubic rami

Iliac

Transverse sacrum fx

32
Q

MC associated injuries with pelvic fx?

A

Chest injury
Long bone
Head

33
Q

Pelvic fx txt?

A

External stabilization with Stryker Hoffman External Fixator

34
Q

Pelvic fx’s - increased risk for:

A

Genitourinary injuries

Post-traumatic arthritis

VTE risk

35
Q

Clinical presentation of femur fx:

A

Pain in the groin, inability to bear weight

Externally rotated, abducted, and shorted

Common to younger and older, with a drop in the middle

36
Q

Three common ways to describe femoral shaft fx’s:

A

Simple
Wedge
Complex

37
Q

Femur fx’s have a high association with what condition that can cause ARDS?

A

Fat embolism

38
Q

Tx for femoral fx?

A

Traction splint emergently

39
Q

Stress fx’s pt population:

A

MC to young females
Recent increase in athletic activity

Distance runners

40
Q

Greater than 50% compression fx of the femoral neck:

A

Surgery

41
Q

Stress fx txt:

A

No set way to do it - pain is the guide

42
Q

What happened when I forgot which side the sun rises from?

A

It dawned on me!

P- 2 - Ortho 2 (5 decks)

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