SAOP1- Hip Lux

  1. The most common type of hip luxation is __________; and it manifests clinically as... (5)
    craniodorsal; partial to non-weight-bearing, toes externally rotated, greater trochanter dorsally displaced, limb shortening, and hip crepitus
  2. What are the requirements to be a candidate forĀ a closed reduction of a craniodorsal hip luxation? (4)
    • uncomplicated luxation
    • first attempt at repair
    • <4-5 days duration (once it become chronic, acetabulum may fill with granulation tissue and prohibit relocation of femoral head)
    • no other orthopedic trauma/ no other limbs affected
  3. What are contraindications for a closed reduction of craniodorsal hip luxation? (4)
    • osteoarthritis
    • hip dysplasia
    • acetabular fracture
    • femoral head fracture
  4. Describe pesudoacetabulum and how it is managed.
    • pseudoacetabulum forms cranial and dorsal to real acetabulum after chronic luxation
    • remodeled and reasonably comfortable and functional articulation
    • conservative management indicated
  5. Describe how closed reduction of craniodorsal manipulation is performed. (3)
    • manipulate to evacuate capsule and granulation tissue
    • ehmer non-weight-bearing sling
    • radiograph to confirm reduction (the most common reason that dos have a bad outcome from closed reduction is that is was never actually reduced)
  6. How is an ehmer sling applied after closed reduction of craniodorsal hip luxation?
    the bandage should go medial to the tibia and internally rotate the leg, forcing it to stay reduced and protecting it from loading
  7. How is caudoventral hip luxation managed? (2)
    • closed reduction
    • hobbles (prevent abduction of hip; these dogs do not need a non-weight-bearing sling)
  8. When caudoventral hip luxation is associated with ___________, open reduction and internal fixation is indicated.
    fracture of the greater trochanter
  9. When is open reduction of hip luxation indicated? (6)
    • other trauma
    • luxated head does not seat well in acetabulum
    • hip has reluxated after previous closed reduction
    • hip has been chronically luxated
    • fractures are present
    • hip dysplasia
  10. Describe the use of a de vita pin in internal fixation of hip luxation..
    • the hip is reduced
    • then vida pin in placed ventral to tuber ischii, across the dorsal margin of the neck of the femur, and then is embedded in the cranial aspect of the ilium
    • offers resistance to lateral and cranial luxation of the head of the femur
  11. What are complications of using a de vita pin for internal fixation of hip luxation? (5)
    • sciatic nerve injury
    • pin migration
    • pin-tract drainage
    • injury to the femoral head
    • septic arthritis
    • [this is high risk- not an ideal way to treat]
  12. What is capsulorraphy?
    • simple capsular reconstruction
    • usually combined with other methods of internal fixation
  13. What are indications for craniodorsal capsular prosthesis? (2)
    • non-repairable capsule tears
    • persistent instability
  14. Describe how craniodorsal capsular prosthesis is performed.
    • 2 screws dorsal to acetabulum and 1 screw in the trochanteric fossa into the femoral neck
    • then 2 figure-8 sutures to secure the femur into the acetabulum
  15. What are methods of internal fixation of hip luxation? (6)
    • de vita pin
    • craniodorsal capsular prosthesis
    • hip toggle
    • transarticular pin
    • femoral head ostectomy
    • total hip replacement
  16. What are cons/ complications of transarticular pins? (5)
    • must be removed at 3-4 weeks or cause articular trauma
    • pin breakage
    • pin migration
    • hip cartilage trauma
  17. The client wants the one defintive procedure to ensure their animal with a luxated hip will not need surgery again. You recommend...
    femoral head ostectomy (all the repair methods carry a risk of re-luxation)
  18. What are indications for femoral head ostectomy? (3)
    • cats and dogs <20kg
    • chronic luxation
    • non-reducible luxation (associated OA, fracture)
  19. What are cons/ complications of FHO? (5)
    • dogs >20-30kg
    • decreased range of motion
    • limb shortening and conformational change
    • medial patellar luxation
    • incomplete recovery of muscle bulk
  20. What is the cut line for FHO?
    medial border of the greater trochanter to just proximal to the lesser trochanter
  21. What is the best option for management in a large dog with a complicated luxation?
    total hip replacement (too big for FHO, not good candidate for internal repair)
Card Set
SAOP1- Hip Lux
vetmed SAOP1