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Hip and knee
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
Palpate all around the hip joint line for any areas of tenderness. Tenderness in specific areas may relate to an underlying pathology: greater trochanter (trochanteric bursitis)lesser trochanter (common with sporting injuries to iliopsoas)ischial tuberosity (common with sporting injuries to hamstring muscles.)
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
Hip fractures extend from the head of the femur to just below the lesser trochanter, and may be classified in relation to the hip joint capsule being intra-capsular or extra-capsular. Intracapsular fractures may be below the head of the femur (subcapital), across the mid-femoral neck (transcervical) or across the base of the femoral neck (basicervical). Extracapsular fractures are outside the hip capsule and include intertrochanteric and subtrochanteric fractures. Strictly speaking, extra-capsular fractures do qualify as neck of femur fractures.
Surgery of the Hip
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Daud TS Chou, Jonathan Miles, John Skinner
Hohmann retractors are inserted around the superior and inferior aspects of the femoral neck, supporting and stabilising the proximal femur and exposing the whole of the intertrochanteric line. Any soft tissues along this line are removed until the superior portion of the lesser trochanter is seen or at least easily palpable.
Computational prediction of the long-term behavior of the femoral density after THR using the Silent Hip stem
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Zainab Al-Hajaj, Pouria Tavakkoli Avval, Habiba Bougherara
Contacts between all surfaces were constructed based on the perfect bonding (i.e. the nodes of the inner surface are merged with the nodes of external surfaces). The contact was modelled using CONTA174 and TARGE170 contact pair element to represent contact and sliding between adjacent surfaces. The cancellous and cortical bones and implant were meshed by Quadratic Tetrahedrons elements (∼SOLID187). The muscle and hip joint reaction forces were applied on the femoral head and greater and lesser trochanters of the model (Figure 2), to simulate the physiological loading. The forces values were identified according to the previous studies reported in literatures (Brand et al. 1994; Duda et al. 1998). To avoid stress concentration, the muscles and hip joint reaction forces were applied on the surface and distributed over several nodes on the greater and lesser trochanter and the femoral head (Avval et al. 2016). The degrees of freedom of nodes (i.e. SOLID187 element has 3 degrees of freedom at each node, translations in the nodal x, y, and z directions) at the distal epiphysis were fixed to create a rigid ground (Figure 3). To avoid stress concentration, the muscles and hip joint reaction forces were distributed over several nodes of greater (and lesser) trochanter and femoral head, respectively (Figure 3).
Relation of mobilization after hip fractures on day of surgery to length of stay
Published in Baylor University Medical Center Proceedings, 2022
James M. Rizkalla, Scott J. B. Nimmons, Asad Helal, Purvi Prajapati, Alan L. Jones
Hip fractures, which encompass fractures that occur from the subcapital femoral neck to the subtrochanteric region 5 cm distal to the lesser trochanter, are the focus of much research and scrutiny due to their significant morbidity and mortality as well as serious economic burden.1,2 Over 300,000 hip fractures occur every year in the USA, with an estimated cost of $9.2 billion annually.1,3–5 Even with continued advancements, in-hospital mortality after hip fracture surgery ranges from 1.5% to 11.5%.6,7 With the vast majority of hip fractures occurring in the >65-year age group, a population estimated to double by 2030, there is need for continued effort to improve outcomes after hip fracture surgery.8 Many studies have shown the benefits of early mobilization not only on short-term outcomes but also on ultimate return to function.9 In this study, the effect of a new protocol for early mobilization on the day of surgery was examined with regards to short-term outcomes and complications. We aimed to better understand the potential benefits and risks of early mobilization in hip fracture patients.
Frequency of ischiofemoral space discrepancy when comparing magnetic resonance images of distinct institutions for the same patient
Published in Baylor University Medical Center Proceedings, 2021
Munif Hatem, RobRoy L. Martin, Scott J. Nimmons, Hal David Martin
Impingement between the lesser trochanter and the ischium is a cause of hip pain and limitation in hip extension.1–5 The ischiofemoral space (IFS) is the distance between the lesser trochanter and the ischium, with values ≤17 mm traditionally indicating ischiofemoral impingement.6 Variation in hip flexion/extension, abduction/adduction, and internal/external rotation during the acquisition of imaging studies is a potential source of variation in IFS.7 Inaccuracy of the IFS measurement may result in radiographic misdiagnosis of ischiofemoral impingement, as well as insufficient or excessive osseous resection in patients surgically treated. This study compared the IFS measured in magnetic resonance imaging (MRI) studies performed in distinct health services for the same patient. The hypothesis is that variability in the IFS is a frequent finding.