Safe Surgical Dislocation of Hip Joint.pptx

Safe surgerical dislocation of hip

1. Safe S urgical Dislocation of Hip Joint Dr. Ashwani Jangir Assistant Professor , Orthopaedics , SP Medical College , Bikaner

2. Safe Surgerical Dislocation - Approach to the hip joint . Based on detailed study of the blood supply to the hip joint . Involve dislocation of hip joint without compromise of femur head vascularity .

3. Original Article -

4. Vascular Anatomy 90 % from Medial Circumflex femoral artery [MCFA] , main blood supply to weight bearing portion of femoral head . 10% from LCFA & artery to ligamentum teres

5. Indication - FAI SCFE Femur head # Acetabular # - superior wall extension Femoral head reshaping osteotomy

6. Surgical Approach Originally through KOCHER LANGENBECK approach. Modification - GIBBSON APPROACH In Gibbson approach proximal incision directed anterior to KL approach . Dissection between TFL & Gluteus maximus . Entire gluteus maximus retracted posteriorly .

7. Patient positioning -

8. INCISION -

9. Superficial surgical dissection -

10. Deep dissection -

11. Trochanteric osteotomy -

12. Capsulotomy -

13. Dislocation of hip joint -

14. Capsule closure -

15. Reduction & Fixation of trochanteric flip -

16. Closure of fascia -

17. Complications - Avascular necrosis - 1 to 5 % in non traumatic case Sciatic nerve palsy - < 1% Delayed / Non union of trochanteric osteotomy Heterotopic ossification - 10 to 20 % , less compare to anterior approach Infection - < 1%

18. THANK YOU !