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Dr P K Sharma Professor Department of Anatomy K G M U , Lucknow
INTRODUCTION Ball and socket type of synovial joint MultiaxialRange of motion restricted (weight bearing)
BONES Femoral head ->1/2 of sphere-BallAcetabulum-vinegar cup-Socket Head of the femur articulates with acetabulum
ARTICULAR SURFACES Head of Femur- hyaline cartilageNonarticular-fovea capitis Acetabulum- Articular surface -horse shoe shaped hyaline cartilage covered
LIGAMENTS OF HIP JOINT Capsular ligament(joint capsule)Ilifemoral ligament-ligament of Bigelow(strongest) Pubofemoral ligament Ischiofemoral ligament Transverse acetabular ligament Acetabular labrum Ligamentum teres femoris.
CAPSULAR LIGAMENT Strong dense fibrous sac Inner fibres circular,outer fibres longitudnal ATTACHMENTS Hip Bone- Femur - .
Hip Ligaments ischiofemoral ligament posterior view of right hipResists adduction and internal rotation. Note: none of these ligaments restrict flexion. posterior view of right hip
ILIOFEMORAL LIGAMENT Ligament of Bigelow strongest Y shaped StemMedial (vertical) Lateralband(oblique) intermediate thin stratum. Anteriorly blends with capsule Prevents hyperextension of hip
PUBOFEMORAL LIGAMENT Base –iliopubic eminence,superiorpubic ramus,obturator crest. Blends with capsule deep to medial band of iliofemoral. Resists abduction and some external rotation.
ISCHIOFEMORAL LIGAMENTWeak Supports capsule from behind From ischium, fibres spiral behind femoral neck attach to greater trochanter
OTHER LIGAMENTS A-Round lig/lig.teres femoris B-Acetabular labrumC-transverse acetabular ligament B A C
STABILITY OF HIP JOINT Depth of articular socket Strong lig.- Muscles-Length ,obliquity of femur neck.
BURSAE AROUND HIP JOINTSubgluteal/ischial bursa Subpsoas/iliopsoas
ARTERIAL SUPPLY Medial circumflex femoral Lateral circumflexObturator artery Superior Inferior gluteal Nutrient artery Blood supply best
MOVEMENTS AND RANGE
LATERAL ROTATORS MEDIAL ROTATORS
APPLIED ASPECTS Dislocation(congenital,acquired)Perthes disease(pseudocoxalgia) Coxa vera and coxa valga Osteoarthritis Fracture neck femur
CONGENITAL DISLOCATIONLoose joint capsule Hypoplastic head Externally rotated short limb Inability to abduct Assymmetry of skin folds of thigh
AQUIRED DISLOCATION Posterior(most common)Joint flexed, adducted, medially rotated – Traumatic- Car driver, dashboard strike-Femur head forced out of acetabulum ,capsule tear is posterioinferiorly.
PERTHES DISEASE Destruction,flattening of head of femurIncreased joint space
COXA VARA In case of Fracture femur neck Perthes disease
COXA VALGA Seen in congenital dislocation of hip,rickets- softening neck of femur
OSTEOARTHRITIS Old age Osteophytes grow on articular ends-painful, limiting movement .
FRACTURE NECK OF FEMUR Intracapsular-Subcapital(avascular necrosis most common) Cervical Basal/intertrochantric Extracapsular-old age
SHENTON’S LINE DISRUPTED CURVEIn case of dislocation and in fracture neck femur. shento
SHOEMAKER’S LINE Straight line from tip of greater trochanter to ASIS upto umblicus. If G.T. elevated in fracture neck Line passes below umblicus. shoe
Iliofemoral ligament takes origin fromA. Iliopubic rami B. Posterior inferior iliac spine C. Anterior superior iliac spine D. Anterior inferior iliac spine
Lurching gait is seen and trendelenburg sign is positive in paralysis of all EXCEPTA. Gluteus maximus B. Gluteus minimus C. Gluteus medius D. Tensor fasciae latae
Amongst the following muscles which muscle is a medial rotator of thighA. Quardratus femoris B. Piriformis C. Gluteus medius D. Obturator internus
The hip joint most commonly dislocates in the following directionA. anterior B. posterior C. superior D. inferior
Hyperextension at hip joint is prevented byA. Iliofemoral ligament B. Ischiofemoral ligament C. Pubofemoral ligament D. Capsular ligament
HIP COMPLEX. Review Bony Articular Surfaces Synovial ball and socket joint: Synovial ball and socket joint: Femoral head. Acetabular fossa. Lunate surface.
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Hip and Thigh General Introduction Anatomy. Hip Joint Ball and Socket –Ball = Femoral Head –Socket = Formed by the three Pelvic Bones Socket called the.
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