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-
Main blood supply of femoral head.
Medial femoral circumflex artery
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Normal femoral neck shaft angle.
- Neonate:160 degree
- Adult:125 degree
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Perthes dzs vs SCFE
- 4-8 yrs.
- Idiopathic avascular necrosis.
- Not a/w Obesity,endocrinopathies.
- Limb in flexion.
- 12-16 yrs.
- Ball at the femur head slips off.
- A/w obesity,endocrinopathies.
- Limb in extension.
- Operative fixation.
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Shentons line
Imaginary line betn inferior border of superior pubic ramus and inferomedial border of neck of femur.
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Neck of femur.
- M/c site:subcapital
- Garden's classification.
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Neck of femur #
- N for non-union.
- N for no ecchymosis.
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Dislocation of hip.
- M/c posterior dislocation.
- Hip:sciatica nerve.
- Knee:popliteal artery.
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Attitude of limb.
- Posterior dislocation:FADIR.
- Anterior dislocation:FABER
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TB HIP.
- Stage of synovitis:FABER,apparent lengthening.
- stage of arthritis:FADIR,apparent shortening.
- Stage of erosion:FADIR,true shortening.
- Night cries,
- Stiffness of hip:first symptom.
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Femur #
- Shock,1000-1500 ml blood loss.
- Fat embolism.
- Kuntscher nail.
- Gallows traction.
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Knee.
- ACL blood supply:middle geniculate artery.
- ACL prevents anterior dislocation of tibia.
- PCL prevents posterior dislocation of tibia.
- ACL attachment:tibial eminence to lateral femoral condyle.
- PCL attachment:tibial eminence to medial femoral condyle.
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Injury to menisci.
- Twisting force,knees are semiflexed.
- Medial menisci:less mobile,injury more.
- M/c:bucket handle tear.
- Inner zone:avascular
- Outer zone:fully vascular.
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Unhappy triad of o' Donoghue.
- ACL tear.
- Medial mensiscus tear.
- Medial collateral ligament tear.
- Bt lateral meniscal tear is more common.
- Most commonly turn meniscus in a/w acute ACL injury:lateral meniscus.
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Prepatellar bursa.
Infrapatellar bursa.
- Housemaid knee.
- Clergyman knee.
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M/s which helps in locking.
M/s which helps in unlocking.
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Tarsal tunnel syndrome.
Cubital tunnel syndrome.
- Posterior tibial nerve.
- Ulnar nerve.
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Ankle joint.
- No dislocation.
- But anterior talo fibular ligament tears first.
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CTEV.
- Equinus:at ankle joint/tibiotalar jt.
- Varus:talocalcaneal/subtalar.
- Adduction:mid tarsal jt.
- First deformity:soft t/s then
- Bony changes.
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Triple arthoidesis.
- Talo-calcaneal/subtalar jt.
- Talonavicular jt.
- Calcaneo-cuboid.
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CTEV t/t.
- Newborn:manipulation alone.
- After 1 month:manipulation and strapping.
- Upto 3 yrs:posteromedial soft t/s release.
- Dennis brown splint used.
- Deformity corrected:
- ALL INDIA EXAM.
Adduction f/b inversion f/b equinus.
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Pagets dzs of bone.
- A/k/a osteitis deformans.
- Osteoclastic activity f/b osteoblastic activity.
- ALP is increased.
- Heart failure n increase risk of osteosarcoma.
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