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Gheorghevici T. tefan, MD
sub coord. Sef lucr.Dr. Cozma Tudor
ischiofemural
pubofemural (cel mai slab)
ligamentul rotund al capului
femural
musculatura: - coaptoare ms.
pelvitrohanterieni scurti posteriori, fesier
mijlociu si micul fesier in opozitie cu m.
abductoare si flexoare.
Anteversia colului femural
1. A. ligamentului rotund
din sistemul obturator
A. iliaca interna
Vascularizatia
capului femural
luxatie centrala/protuzie
intrapelviana in micul bazin
acetabulara de cap femural
EXPLORARI PARACLINICE
Examen radiografic
Examen CT
Examen IRM
Examen scintigrafic
Examen radiografic
Clasificarea Epstein
Clasificarea Thompson si Epstein
Clasificarea Pipkin
Clasificarea Levin
Clasificarea Stewart and Milfords
Clasificare AO/OTA
Clasificarea Epstein
Tip I: Luxatii superioare inclusiv pubiene sau
suprapubiene
Tip IA: Fara fracturi asociate
Tip IB: Fracturi asociate sau tasari ale capului
femural
Tip IC: Fracturi asociate ale acetabulului
Tip II: Luxatii inferioare inclusiv obturatorii si
perinale
Tip IIA: Fara fracturi asociate
Tip IIB: Fracturi asociate sau tasari ale capului
femural
Tip IIC: Fracturi asociate ale acetabulului
Clasificarea Thompson si Epstein
luxatie ireductibila
leziunea iatrogenica a n. sciatic
reducere incoercibila cu fragmente
incarcerate/ interpozitie de parti moi
reducere incoercibila cu fractura tip I Pipkin
fractura de femur controlateral
Anterior Smith-Petersen/ Hardinge
Anterolateral Watson-Jones
Position of hip.
Smith-Peterson approach
Watson-Jones is an alternate approach
1. Allows visualization and retraction of interposed
tissue.
2. Placement of Schanz pin in intertrochanteric
region of femur will assist in manipulation of the
proximal femur.
3. Repair capsule, if this can be accomplished
without further dissection.
1. Irreducible Hip Dislocation: Posterior
1. Kocher-Langenbeck approach.
From:
Acetabulum Fracture (weight-bearing
portion).
Femoral Head Fracture (any portion).
Interposed tissue.
Improves gait
Prevents contracture
Infection
Incidence 1-5%
Lowest with prophylactic antibiotics and
limited surgical approaches
Infection: Treatment Principles