clinical anatomy of the hip
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Clinical Anatomy of the Hip
Will CollettPeer Support 2014
Avascular necrosis Superior Gluteal Nerve Injury Inferior Gluteal Nerve Injury Thomas Test Injection Site
Objectives
What makes the femoral head susceptible to AVN?
Medial and lateral circumflex arteries and ligamentum teres artery
Intracapsular Vs Extracapsular How can we injure the hip causing AVN?
# NOF Car crash
What are the signs and symptoms of AVN? # NOF – shortened and externally rotated Pain, reduced movement, Weight bearing
Avascular Necrois
Diagnosis?
Avascular necrosis
Intracapsular
Extracapsular
Innervates?
Lost ability to? Abduct the hip
Trendelenburg gait or sign?
Superior Gluteal Nerve Injury
Superior gluteal nerve (L4-L5)
Gluteus Medius & Minimus(L4-L5)
GAIT
Innervates?
Lost ability to? ◦ Prevent trunk tipping forwards during gait◦ Extend the hip
Gait? ◦ lurching backward when the weaker limb is on the floor during walking (heel strike)◦ Buttock wasting◦ Hamstring Compensation
Inferior Gluteal Nerve Gluteus Maximus
(L5-S1)
Thomas Test
Method 1 - Vertical line through
highest point of iliac crest - Horizontal line midway
between ischial tuberosity and highest point of iliac crest
Intramuscular Injection Method 2
- Vertical line through highest point of crest- Line from PSIS to the greater trochanter
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