OF THE TOTAL HIP JOINT关节髋关节脱位ppt课件.pptVIP

Symptoms and Signs of total hip dislocation - feels very painful popping in the total hip joint. - keeping the whole leg stiff and firmly pushed to the midline and the other leg - In patient with many dislocations in the past, the pain may be only moderate Treatment of the first dislocation CR: Longitudinal traction and slight abduction when the head is at the level of the acetabulom Post care: adduction orthosis (15`), traction, spica cast for 6 weeks An 80-years man, Department of Orthopedic Surgery, Ghaem Hospital 1383 It dislocated for 2 times - We manage the patients with a spica cast The repeated dislocation The first dislocation that occurred during the first three postoperative weeks and was treated accordingly has a low risk of recurrence: about 20 to 30 % during the next years. After another (second) dislocation the risk that the total hip will continue dislocate increases substantially; according to some statistics about 50% of patients who had two dislocations will continue to dislocate their total hip repeatedly; this risk is especially high if the total hip operation was done through posterior approach or if the total hip is a model with a small femoral head. Examinations after second and further dislocations Comprehensive x-ray CT-Scan Fluoroscopic study under sedation OPERATIONS TO IMPROVE THE STABILITY 1. Revision of faulty positioned components 2. Operations to relieve slackness of soft tissues around a total hip A: soft tissue advancement B: Change the length of neck C: Revision D: Constrained cups E: Bipolar hip prosthesis Dislocation of the polyethylene liner Dislodgment of the polyethylene liner is an increasingly common complication following total hip arthroplasty What are the symptoms painful limp and shortening of the limb Treatment Operation of the dislodged liner is necessary, the surgery should be done as soon as possible References 1. Bourne J, Mehin R.: J Arthroplasty 2004, Suppl 1, 111- 4 2. C