Hip Dislocation – Everything You Need To Know – Dr. Nabil Ebraheim
what is a priority concern for a client who has a hip dislocation? This is a topic that many people are looking for. chibariku.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, chibariku.com would like to introduce to you Hip Dislocation – Everything You Need To Know – Dr. Nabil Ebraheim. Following along are instructions in the video below:
Dislocation head dislocation can be a symbol dislocation or it can be a fracture dislocation dislocation that involve the femoral head or the posterior wall of the this location of hab. Usually is a posterior type. However on the rare situation it can be anterior dislocation in posterior dislocation of the hip.
The lower limb will be flexed abducted and internally rotated here is a normal position of the lower extremities and the ear in the position of the lower extremity after posterior dislocation of the help in anterior hip dislocation. The lower extremity will be extended abducted and externally rotated. And you can see the position of the lower extremity after anterior hip.
Dislocation here is a man kill inferior dislocation. We call it the obturator type and the extremity will be flexed. Abducted and externally rotated srimati will not be extended as in other types of anterior dislocation of the hip hemp dislocation of any type is an emergency.
It must be reduced in less than six hours of injury. After reduction of the help try to get a ct scan to see any loose fragments in the joint. Youll get an x.
Ray. First. And then you will get ct scan after that the ct scan will clearly outline the bony injury.
The ct scan will be helpful to check for congress reduction for absence of fracture. Absence of marginal impaction or absence of loose fragment pieces inside. The joint marginal impaction is more common in posterior establish all fractures and it can lead to instability and if not recognized it can lead to an instability of the help the size of the posterior wall fracture has an effect on the stability of the hip joint.
If the patient has an irreducible dislocation of the hip. Didnt you need to do an emergency surgery to reduce the hip reduction of the hip cannot wait till tomorrow or the day after tomorrow. It got to be done urgently help dislocation with or without associated fracture can cause complications such as avascular necrosis.
The risk of avascular necrosis depends on the interval between the injury and reduction of the dislocation ancient reduction of the help is mandatory to avoid this complication posterior hip dislocation can also cause setec nerve palsy reduce the hem and recheck. The sciatic nerve function. Always reduce the help early closed reduction.
Should be done in less than six hours check. The sciatic nerve. Before reduction and after reduction.
The common creamier nerve is the nerve thats usually affected and that will cause weakness in those deflection of the ankle with loss of extension of the toes. The entry can occur in varying degrees of severity and check for for drop or check sensation in the first web space injury to the ascetic nerve usually appears from dislocation of the hip and not from reduction of the head the length of time the herb remains dislocated influences the incidence and the severity of a major setec nerve injury.
There is approximately 10 incidence of certain nerve injury from posterior hip dislocation. The partial recovery of the sciatic nerve. Who cares in about 60 to 70 percent of patients.
The patient usually requires an anti foot dropped splint to prevent aquinas of the ankle. When you have a posterior dislocation of the hip all check for injuries of the knee such as woody dashboard injury. The fault of the injury is transmitted from the knee to the hip they may be associated posterior cruciate ligament injury or a meniscus tear examined any for injuries.
An mri may be needed in case of high energy trauma always look at the chest. They might be a tear of the horta look for widening of the mediastinum on chest x. Rays.
There is a concern of deceleration injury involving the a walter when the patient have helped dislocation help joint dislocation may be associated with establish raksha or fracture of the femoral head. And you call that pipkin fracture. The anterior hip dislocation will have a higher rate of femoral head impaction than the posterior hip dislocations treatment of help this location you do emergency closed reduction of the health within six hours daily clothes reduction is done to avoid avascular necrosis of the head after reduction of the help you will do mobilization of the patient would protected weight bearing crutches for approximately four weeks after you completed the clothes reduction and the patient has an associated fracture of the establish s.
The stability especially if the fragment is not too large usually between 20 to 40 percent fragment size the hip stability is undetermined and we dont know if that patient will need surgery or not who dont know if that fragment is important for instability of the hip or not we know that the help is usually stable. If the fragment size is less than 20 and well call it a stabler lib fracture. We also know if the fracture fragment is big like 40 that fragment need to be fixed.
Because the hip will be definitely unstable. If we dont fix it when the size of the fragment is not big and not a small the best method to assess the stability of the hem. Is by examination of the patient.
Under general anesthesia. Utilizing fluoroscopy. You will assess the posterior wall stability with the obturator of like veal.
Youll put the help in flexion abduction. And add an axial load check the medial clear. Space for opening opening of the medial clear space.
Suggest. Instability. When you are taking an exam.
And theres multiple trauma patients and a lot of injuries. Always look at the corner of the page.
Where they have the photographs because youll have help dislocated and the first thing you want to do for the treatment of the patient is to reduce the dislocated help thank you very much i hope that was helpful you n them already i recommend you choose the body system that youre asking about so. If somebody has abdominal pain. Youre going into that ro s.
And asking the full thing not just like nausea vomiting like nausea. Vomiting diarrhea. Constipation.
Blood in your stool weight loss. Like coffee ground stool like etc. Etc.
All that stuff so asking the entire r os and hopefully. Its in your ehr. Which is right in front of you if you use a laptop in the room.
Otherwise you can use a checklist right of like all the different questions you should ask and then ask them what the associated factors you want to think about what are the associated body systems right so gi and g. You go together. So ask all the geo systems as well depending on the location of again anatomy based differentials.
If were talking about epigastric pain. It could be your pulmonary system as well right so you just want to think about that you could ask all the other wise questions. If you really wanted to but anyway.
Hopefully that will help kind of guide that the next one is relieving factors and i have some feelings about this point so relieving factors not only are you asking things like what are they using to help that their symptoms right now. So you have abdominal pain that the epigastric are you using thats burning are you using any antacids or things like that but also hyper important is that for some reason patients typically and my experience have not automatically volunteered this and maybe its because im intimidating or the healthcare system is intimidating. Im not sure but if theyve ever had this symptom before or if theyve gotten any treatment for it before so pausing on the abdominal pains example for a second.
I had a patient a couple years ago who had a little bit of cognitive impairment which may have been part of this but um she was complaining of shoulder pain that radiated down from her shoulder to her wrist. And i was like i have no idea what this is and i dug and i dug and i dug and i asked all the questions and i excused myself i looked on things on up to day. And i asked more history questions.
I came up with a plan of karin. I was like you know what i think you have really bad carpal tunnel. Im so proud of myself was such a beautiful diagnosis because of fyi that can happen.
Its so bad that it radiates up to their shoulder. And im talking about bracing and injections and she might need surgery and .
Thank you for watching all the articles on the topic Hip Dislocation – Everything You Need To Know – Dr. Nabil Ebraheim. All shares of chibariku.com are very good. We hope you are satisfied with the article. For any questions, please leave a comment below. Hopefully you guys support our website even more.