Pavlik harness has become common treatment for infants younger than about 6 months of age Hip spica cast is the most common treatment for preschool-age children (up through about 6 years). Angulation up to about 15° in the coronal plane and 20° to 25°in the sagittal plane is acceptable. 6-10 years: Nonrigid nails: mainstay of treatment Submuscular plates are ideal…
Modes of injury : stretching, compression and laceration Distal segment undergoes Wallerian degeneration Functional recovery during regeneration (in order)-sympathetic activity: Pain, Temperature sensation, Touch, Proprioception, Motor function Seddon and Sunderland classifications commonly used NCV and EMG are useful in diagnosing and assessing recovery Neurotmesis requires surgical end to end primary repair or nerve grafting Other treatment options include neurotization, nerve transfer, and…
Combination of fractured bone with an existing prosthesis makes these fractures challenging Mortality rate within one year following surgical treatment of periprosthetic femoral fractures is high If the Stem/component loose then revision of the component, with adjunctive stabilization of the fracture with a plate or allograft/plate composite is required. If the Stem/component well fixed then the component should be retained…
1 in 10000, 4-8 years of age, males affected more Insidious onset, may cause painless limp, intermittent hip, knee, groin or thigh pain Loss of internal rotation and abduction is classical Pathophysiology : Osteonecrosis occurs secondary to disruption of blood supply to femoral head; Revascularization with subsequent resorption and later collapse X Ray- AP of pelvis and frog leg lateral Bone scan and…
Limb discrepancy causes patient dissatisfaction, pain, gait disturbance etc Postoperative goal is a final LLD of <1 cm Evaluate and document any structural and apparent limb-length discrepancy before total hip arthroplasty for later comparison Measurement of LLD on a preoperative anteroposterior pelvic radiograph is best performed using the inter-teardrop line and the femoral head center as the landmarks Hip position…
Dislocation is the cause of 15% of THA revision surgeries Surgeon factors : Component Positioning, Implant Choice, Surgical Approach Low-volume surgeons and patients with elevated BMI increase the risk of malpositioning No convincing evidence that fluoroscopic or robotic assistance helps Increasing the size of the femoral head (up to 38 mm) provides greater resistance to dislocation Dual-mobility designs also raise…
