The Hip - book

Radiology of Pelvic Fractures

  – See: Radiology of the Acetabulum – Discussion:     – instability = cephalic displacement of posterior sacroiliac complex of at least 5-15 mm on inlet and outlet views;     – look for gap (rather than impaction) posteriorly, & frx of 5th lumbar transverse process or avulsion of sacrospinous ligament; – Pertinent Radiographs:       – AP … Read more

Radial Head Prosthetic Replacement

– Discussion: – indicated for comminuted radial head frx which occur w/ concomitant MCL injury, dislocation, or RU joint disruption (Essex Lopresti  Fracture); – will serve as spacer & will prevents proximal migration of radius; – w/ RU joint disruption, radial head spacer alone does not restore satisfactory axial stability w/o pinning the distal radioulnar … Read more

Pulmonary Contussion

– See: Cardiac Contussion:  – primary complication is comprimised oxygenation;  – due to intersitial hemorrhage with alveolar collapse and alveolar flooding  – shunting, results in hypoxia that is relatively refractory to enhanced inspiratory oxygen concentration;  – pulmonary contusions are usually quite localized;  – Management:  – PEEP and continuous positive airway pressure   – over-agressive diuresis or … Read more

Proximal Row Carpectomy

– Discussion: – coverts a complex link joint to a simple hinge by creating a radiocarpal articulation; – motion between the radius and capitate is both translational and rotational, which has the effect of dissipating forces on the radius; – expect 60-80% of contralateral motion (w/ about an 80% flexion-extension arc); – expect preservation of … Read more