Reparație articulară după luxație.

Luxatie la picior

Leah Emanuel Luxaţia traumatică a şoldului Gheorghevici T. Ştefan, MD sub coord.

Îngrijirea luxației umărului

Sef lucr. E, rezista la 3. Position of hip. Physical Examination: Classical Appearance Anterior Dislocation: Reparație articulară după luxație external rotation, less-pronounced abduction and flexion.

O luxatie este provocata de un soc sau de o miscare fortata, mult mai rar de o malformatie. O luxatie partiala, sau subluxatie, apare cand osul deplasat a alunecat intr-o parte dar inca ramane in contact pe o anumita suprafata cu al doilea os al articulatiei. Simptomele unei luxatii sunt caracteristice: durere, deformatie si imposibilitatea de a misca articulatia. Radiografia permite confirmarea diagnosticului. O luxatie poate fi asociata cu o fractura a unuia sau ambelor oase.

CT Scan Most helpful after hip reduction. Reveals: Non-displaced fractures.

reparație articulară după luxație

Congruity of reduction. Intra-articular fragments.

Prima etapă a tratamentului de luxație

Size of bony fragments. Reduction Maneuvers Allis: Patient supine. Requires at least two people. Stimson: Patient prone, hip flexed and leg off stretcher. Requires one person. Impractical in trauma i. Hip flexed to 90o 2.

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If hip remains stable, apply internal rotation, adduction and posterior force. The amount of flexion, adduction and internal rotation that is necessary to cause hip dislocation should be documented. Irreducible Hip Requires emergent reduction in O. Pre-op CT obtained if it will not cause delay.

One more attempt at closed reduction reparație articulară după luxație 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. Hip Dislocation: Indications for Operative Treatment 1. Irreducible hip dislocation 2.

reparație articulară după luxație

Hip dislocation with femoral neck fracture 3. Incarcerated fragment in joint 4. Incongruent reduction 5.

Entorsele: entorsa glezna, genunchi - Simptome, tratament, recuperare

Unstable hip after reduction 1. Allows visualization and retraction of interposed tissue. Placement of Schanz pin in intertrochanteric region of femur will assist tratarea articulațiilor în ape minime manipulation of the proximal femur. Repair capsule, if this can be accomplished without further dissection.

Irreducible Hip Dislocation: Posterior 1. Kocher-Langenbeck approach. Remove interposed tissue, or release buttonhole.

reparație articulară după luxație

Repair posterior wall of acetabulum if fractured and amenable to fixation. Difficult to fix femoral head fracture from posterior approach without transecting ligamentum teres.

Three Options 1. Detach femoral head from ligamentum teres, repair femoral head fracture with hip dislocated, reduce hip.

reparație articulară după luxație

Close posterior wound, fix femoral head fracture from anterior approach either now or later. Ganz trochanteric flip osteotomy.

Afecțiuni ale umărului » Dr. Predescu

Best option not known: Damage to blood supply from anterior capsulotomy vs. These will be discussed in detail in femoral head fracture section.

reparație articulară după luxație

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.

Thus, Kocher-Langenbeck approach.

Entorsă acută a gleznei - Wikipedia

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: dislocation was anterior and, fragment is readily accessible anteriorly. Irreducible fracture-dislocation of the hip: a severe injury with a poor prognosis.

Informatii generale despre entorse O entorsa este o intindere sau rupere a ligamentelor - benzile dure de tesut fibros care leaga doua oase in articulatii. Glezna si genunchiul sunt cele mai obisnuite articulatii in care pot aparea entorsele.

J Orthop Trauma.

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