ANATOMIE,MEDICALE,OPERATII. Calin Todor; videos; views by dockamal Play next; Play now. Video Disectia soldului si coapsei. Croitor Gh, Anatomia funcţională şi biomecanica şoldului, Ed. Prometeu, Chişinău, 6. Ivan Gh, Coxartroza, Editura Scrisul Românesc, Craiova, . 7. Anatomia funcţională şi biomecanica şoldului. Croitor Gh; Ed. Prometeu, Chişinău,; Bazele teoretico-metodice ale kinetoterapiei în bolile reumatice.
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We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Published by Barnaby Stevens Modified about 1 year ago. E, rezista la kN, ischiofemural pubofemural cel mai slab ligamentul rotund al capului femural. Ramuri cervicale ascendente artere cicumflexe artera femurala profunda artera femurala comuna artera iliaca externa aorta risc foarte mare de lezare in luxatia traumatica a soldului.
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.
Luxatie cu un singur fragment major al peretului posterior acetabular Tip III: Luxatie cu fractura tavanului acetabular Tip V: Luxatie cu fractura capului femural. Luxatie posterioara a soldului cu fractura capului femural caudal de fovea capitis Tip II: Luxatie posterioara a soldului cu fractura capului femural proximal de fovea capitis Tip III: Complicatii locale imediate compresiunea n. Fracturile de perete posterior cotiloidian fac dificila aprecierea stabilitatii.
Direction of applied force. Classical Appearance Posterior Dislocation: Hip flexed, internally rotated, adducted.
Classical Appearance Anterior Dislocation: Extreme external rotation, less-pronounced abduction and flexion. Pain with attempted motion of hip.
Luxaţia traumatică a şoldului – ppt download
Should allow diagnosis and show direction of dislocation. Femoral head not centered in acetabulum. Femoral head appears larger anterior or smaller posterior. Usually provides enough information to proceed with closed reduction. AP pelvis, Lateral Hip x-ray. Judet views of pelvis. CT scan with mm cuts.
Inlocuirea de sold
Size of bony fragments. Has not been shown to be of benefit in acute evaluation and treatment of hip dislocations. Emergent Treatment Dislocated hip is an emergency. Evaluation and treatment must be streamlined.
Literature supports decreased AVN with earlier reduction. Conscious sedation is acceptable.
Patient is to be intubated emergently in Emergency Room. Patient is being transported to Operating Room for emergent head, abdominal or chest surgery. Take advantage of opportunity. Requires at least two people. Patient prone, hip flexed and leg off stretcher.
Impractical in trauma i. Stands on stretcher Gently flexes hip to Applies progressively increasing traction to the extremity Applies adduction with internal rotation Reduction can often be seen and felt.
The amount of soldulyi, adduction and internal rotation that is necessary to cause hip dislocation should be documented. Large posterior wall fractures may make appreciation of dislocation difficult. Pre-op CT solxului if it will not cause delay. One more attempt at closed reduction in O. Repeated efforts not likely to be successful and may create harm to the neurovascular structures or the articular cartilage.
Surgical approach from side of dislocation. Nonoperative Treatment Solddului hip stable after reduction, and reduction congruent. Touch down weight-bearing for weeks. Repeat x-rays before allowing weight-bearing. Indications for Operative Treatment Irreducible hip dislocation Hip dislocation with femoral neck fracture Incarcerated fragment in joint Incongruent reduction Unstable hip after reduction. Anterior Smith-Peterson approach Watson-Jones is an alternate approach Allows visualization and retraction of interposed tissue.
Placement of Schanz pin in intertrochanteric region of femur will assist in manipulation of the proximal femur.
Repair capsule, if this can be accomplished without further dissection. Remove interposed tissue, or release buttonhole. Repair posterior wall of acetabulum if fractured and amenable to fixation. Difficult to fix femoral head fracture from posterior approach without transecting ligamentum teres. Close posterior wound, fix femoral head fracture from anterior approach either now or later.
Ganz trochanteric flip osteotomy. Best option not known: Damage to blood supply from anterior capsulotomy vs. These will be discussed in detail in femoral head fracture section. Hip Dislocation with Femoral Neck Fracture Attempts at closed reduction potentiate chance of fracture displacement with consequent increased risk of AVN.
If femoral neck fracture is already displaced, then the ability to reduce the head by closed means is markedly compromised. Thus, closed reduction should not be attempted.
If fracture is non-displaced, stabilize fracture with parallel lag screws first. If fracture is displaced, open reduction of femoral head into acetabulum, reduction of femoral neck fracture, and stabilization of femoral neck fracture.
Incarcerated Fragment Can be detected on x-ray or CT scan. Surgical removal necessary to prevent abrasive wear of the articular cartilage. Posterior approach allows best visualization of acetabulum with distraction or intra-op dislocation.
Anterior approach only if: Acetabulum Fracture weight-bearing portion. Femoral Head Fracture any portion. Requires reduction and stabilization fracture. Labral detachment or tear Highly uncommon cause of instability. Its presence in the unstable hip would justify surgical repair. MRI may be helpful in establishing diagnosis. In general, dislocations with associated femoral head or acetabulum fractures fare worse. Dislocations with fractures of both the femoral head and the acetabulum have a strong association anatommia poor results.
Irreducible hip dislocations have a solfului association with poor results.
Osteoartrita soldului | Blausen Medical
Irreducible fracture-dislocation of the hip: Results are best if hip reduced within six hours. May be unavoidable in cases with severe cartilaginous injury. Incidence increases with associated femoral head or acetabulum fractures.
Efforts to minimize osteoarthritis are best directed at achieving anatomic reduction of injury and preventing abrasive wear between articular carrtilage and sharp bone edges.
Some cases involve pure dislocation with inadequate soft-tissue healing — may benefit from surgical imbrication rare. Can occur from detached labrum, which would benefit from repair rare. Pelvic or intertrochanteric osteotomy could alter the alignment of the hip to improve stability. Bony block could also provide stability. Higher if patient has altered sensorium. In NO Case should a hip dislocation be treated without reduction. Nerve stretched, compressed or transected.
Allows localization of injury in the event that surgery is required.