posterior
Approach
Options
Direct Lateral - transgluteal
Postero-lateral (AKA posterior) - release short external rotators
Direct Anterior
Results
Gait / outcomes
Meermans et al Bone Joint J 2017
- systematic review of 42 studies comparing Direct Anterior / Posterior / Lateral
Traumatic hip dislocation
Incidence
Very rare
Associated Injuries
SH type 1 femoral epiphysis most common
Management
Closed Reduction
Assess concentric reduction
Assess stability
Apply spica / traction for 2 weeks
Shoulder
Approaches
Anterior
Anterolateral
Posterior
Anterior Approach / Deltopectoral
Indications
- shoulder stabilization
- arthroplasty
- fracture fixation
Approach
Position
- beach chair
- upper body elevated 30- 40o / reduces venous pressure and bleeding
Hip
Approaches
Anterior
Anterolateral
Lateral
Posterior
Medial
Anterior Approach / Smith Peterson
Indications
- neonatal hip sepsis
- open reduction hip DDH
Techique
Position
- supine
- sandbag under buttock
- free drape leg
Landmarks
Knee
Approaches
Medial Parapatellar
Medial
Lateral
Posterior
Modified Posterior
Medial Parapatellar Approach
Indications
Synovectomy
Patellectomy
TKR
Technique
Hip Dislocation
Incidence
Young men
Posterior / Anterior 9:1
Aetiology
High velocity injury
- head direction at impact decides direction of dislocation
Anterior Dislocation
Externally rotated & abducted leg
- flexion = inferior dislocation