Chapter 17 The Thigh, Hip, Groin, and Pelvis.ppt

* * * * * * * * * * * * * * Legg-Calve’-Perthes Disease (continued) Care Bed rest to reduce chance of chronic condition Brace to avoid direct weight bearing Early treatment and head may reossify and revascularize Complication If not treated early, will result in ill-shaping and osteoarthritis in later life Slipped Capital Femoral Epiphysis Cause of Condition May be growth hormone related 25% of cases are seen in both hips Epiphysis slips from femoral head in backwards direction due to weakness in growth plate May occur during periods of elevated growth Signs of Condition Pain in groin that comes on over weeks or months Hip and knee pain during passive and active motion; limitations of abduction, flexion, medial rotation and a limp Management W/ minor slippage, rest and non-weight bearing may prevent further slippage Major displacement requires surgery If undetected or surgery fails severe problems will result Iliac Crest Contusion (hip pointer) Cause of Injury Contusion of iliac crest or abdominal musculature Result of direct blow Signs of Injury Pain, spasm, and transitory paralysis of soft structures Decreased rotation of trunk or thigh/hip flexion due to pain Care RICE for at least 48 hours, NSAID’s, Bed rest 1-2 days in severe cases Referral must be made, X-ray Padding should be used upon return to minimize chance of added injury Osteitis Pubis Cause of Injury Seen in distance runners Repetitive stress on pubic symphysis and adjacent muscles Signs of Injury Chronic pain and inflammation of groin Point tenderness on pubic tubercle Pain w/ running, sit-ups and squats Management Rest, NSAID’s and gradual return to activity Acute Fracture of Pelvis Cause of Injury Result of direct blow or blunt trauma Signs of Injury Severe pain, loss of function, shock Care Immediately treat for shock Refer to physician Seriousness of injury dependent on extent of shock and possibility of internal injury Stress Fractures Cause of injury Repetitive abnormal overused forces Sign