Anatomy axis of femoral neck forms angle of approx 135 deg w/ femoral shaft, and is anteverted from the frontal plane by variable amount (- 4 to 36 deg, average 10 to 20 deg in Caucasians); distinct cortex surrounds the cancellous bone of the neck, the center of which becomes progressively empty with age (Ward’s triangle); center of … Read more
– See: proximal femoral shaft fractures / – Discussion: – definition: – between lesser trochanter and 5 cm distal, even as far as center of isthmus of the femoral shaft; – technically starts below the lesser tuberosity; – medial and posteromedial cortex is a site of high compressive forces, while lateral cortex experiences high tensile stresses (forces … Read more
– Discussion: – arises from ascending cervical arteries – epiphyseal arterial branches form at subsynovial intra articular ring, and go on to enter the head of the femur; – disruption of this arterial ring occurs from high femoral neck frx; – these pts … Read more
– Discussion: – classifaction and fracture stability – frx stability is based on presence or absence of posteromedial butress; – farther down shaft of femur primary frx is located, greater incidence of delayed union and implant failure; – forces acting on hip joint … Read more
– See: – Ulnar Nerve: – Anatomy & Sites of Compression of Cubital Tunnel: – Surgical Considerations: – transposition can entail subQ or submuscular transposition with excision of medial intermuscular septum, and release of arcade of Struthers; – in the presence of H.O. the nerve should be … Read more
– Discussion – Examination of Patellofemoral Joint – exam considerations: – generalized hyperlaxity – femoral anteversion – vastus medialis obliquus atrophy – genu valgum – external tibial torsion – patellar dysplasia – trochlear dysplasia – patella alta – pes planus – Radiographic Features: (see: radiographic evaluation of the knee) – lateral view – look for … Read more
– Discussion: – occur as the result of repetitive loading below yeild strength & are most common in lower extremity (metatarsals > calcaneus > tibia); – Matheson, et al.: 370 athletes with stress fractures tibia (49.1%), tarsals (25.3%), metatarsals (8.8%) and bilateral stress fractures in 16.6% of cases; – focal structural … Read more
– Discussion: – stress frx of femoral neck are relatively uncommon injuries, with most reports involving military recruits & athletes who are subjected to increased physical demands; – like most stress frx, women are most often affected and it is important to inquire about amenorrhea and occult eating disorders; … Read more
– Discussion: – stress shielding is the redistribution of load (and consequently stress onthe bone) that occurs when the femoral head is replaced by the femoral component of a total hip replacement; – stress on proximal 10 cm of femoral cortex is reduced, because much of the load bypasses this region and … Read more