七年制醫(yī)學課件專外2關節(jié)脫位(英文)-資料下載頁
2024-10-04 16:54本頁面
【正文】 posterior dislocation ? anterior dislocation ? central dislocation Posterior dislocation of hip Mechanism of dislocation ? while hip is flexed, violence directed along the shaft, then femur head is pushed out of the acetabulum,as often occurs in the motor accidents ? it require a moderately servere force to dislocate a hip The knee strike against the dashboard Clinical features and diagnosis ? The patient presents with a history of severe trauma ? Pain and swelling at the hip ? Deformity : flexion,adduction, internal rotation associated with a shortening of the leg Clinical features and diagnosis ? The head of femur may be felt in the gluteal region ? Xray Complications ? Sciatic nerve injury ? A chip fracture of the posterior lip of the acetabulum ? Avascular necrosis of the femoral head ? Myositis ossificans Treatment 1 closed reduction (Allis method): ? General anaesthesia ? Patient is supined on the floor or hard board ? Assistants grasp the pelvis firmly ,the surgeon flexs the hip and knee at a right angle ,and exerts an axial pull. ? Ususlly one hears a sound of reduction after which it bees possible to move the hip in all direction freely . ? Fixation:the leg is kept in light traction with the hip abducted. (skin traction for 3 weeks ) Treatment 2 open reduction Indication ? Closed reduction falls,usually in those presenting late. ? The acetabular fragment is large and is from the weightbearing part of the acetabulum. ? There is a intraarticular loose fragment not allowing reduction.
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