Orthopedics - Disorders of the Hip and Knee
1. What are most pelvic fractures/dislocations caused by?: - MVAs
- falls from heights
2. Describe the anteroposterior compression MOI for pelvic fractures/disloca-
tions.: - creates external rotation of hemipelvis and rupture of pelvic floor and anterior SI ligaments
- causes rupture of vessels in the pelvic area
3. Describe the lateral compression MOI for pelvic fractures/dislocations.: - creates
compression fractures of sacrum and disruption of posterior sacroiliac ligament complex
4. Describe the combined external rotation MOI for pelvic fractures/disloca-
tions.: - abduction, which is common in motorcycle accidents
5. What is the MOI of a vertical shear fracture?: - fall from heights, causing fracture in several
areas in the pelvis
6. What is a radiograph view that you always order for pelvic fractures?: - AP pelvis
,7. If the patient is hemodynamically stable, what imaging do you obtain for a
pelvic fracture?: - pelvic inlet and outlet x-ray views
8. If you suspect acetabular fracture, what imaging should you obtain?: - obturator
or oblique pelvis x-rays
9. What is the ATLS protocol for unstable pelvic fractures?: - ABCs and manage the patient
hemodynamically
10. What is a common cause of death due to pelvic fracture?: - hemorrhage and shock
11. What may widening of the symphysis pubis indicate?: - urologic injury
12. What are common complications and associated injuries of pelvic fractures?-
: 1. Urogenital injuries
- very common with pelvic fractures
2. Neurologic injury
- L5-S1 nerve root injuries
,3. Thrombosis
- DVT in pelvis
4. Hemorrhage
13. How are open pelvic fractures treated?: - multidisciplinary approach
, 14. Who are hip fractures and dislocations MC in?: - older patients over 55 years old
15. What is the main cause of hip fractures and dislocations?: - fall from standing
height/trip and fall
16. How are almost all hip fractures treated?: - surgically within 24 hours
17. What is the prognosis after femoral neck and intertrochanteric fractures?: -
14-36% of patients will suffer mortality after one year
18. What is a major complication of treating hip fractures closed?: - DVT
19. What is the articulation of the hip joint?: - acetabulum and the head of the femur
20. How does the total force acting across the joint compare when standing on
one leg versus when running?: - total force across the joint is 2.5 times body weight when standing on
one leg and 5 times body weight when running
21. Where do femoral neck fractures anatomically occur?: - occur between trochanters
distally and head proximally
1. What are most pelvic fractures/dislocations caused by?: - MVAs
- falls from heights
2. Describe the anteroposterior compression MOI for pelvic fractures/disloca-
tions.: - creates external rotation of hemipelvis and rupture of pelvic floor and anterior SI ligaments
- causes rupture of vessels in the pelvic area
3. Describe the lateral compression MOI for pelvic fractures/dislocations.: - creates
compression fractures of sacrum and disruption of posterior sacroiliac ligament complex
4. Describe the combined external rotation MOI for pelvic fractures/disloca-
tions.: - abduction, which is common in motorcycle accidents
5. What is the MOI of a vertical shear fracture?: - fall from heights, causing fracture in several
areas in the pelvis
6. What is a radiograph view that you always order for pelvic fractures?: - AP pelvis
,7. If the patient is hemodynamically stable, what imaging do you obtain for a
pelvic fracture?: - pelvic inlet and outlet x-ray views
8. If you suspect acetabular fracture, what imaging should you obtain?: - obturator
or oblique pelvis x-rays
9. What is the ATLS protocol for unstable pelvic fractures?: - ABCs and manage the patient
hemodynamically
10. What is a common cause of death due to pelvic fracture?: - hemorrhage and shock
11. What may widening of the symphysis pubis indicate?: - urologic injury
12. What are common complications and associated injuries of pelvic fractures?-
: 1. Urogenital injuries
- very common with pelvic fractures
2. Neurologic injury
- L5-S1 nerve root injuries
,3. Thrombosis
- DVT in pelvis
4. Hemorrhage
13. How are open pelvic fractures treated?: - multidisciplinary approach
, 14. Who are hip fractures and dislocations MC in?: - older patients over 55 years old
15. What is the main cause of hip fractures and dislocations?: - fall from standing
height/trip and fall
16. How are almost all hip fractures treated?: - surgically within 24 hours
17. What is the prognosis after femoral neck and intertrochanteric fractures?: -
14-36% of patients will suffer mortality after one year
18. What is a major complication of treating hip fractures closed?: - DVT
19. What is the articulation of the hip joint?: - acetabulum and the head of the femur
20. How does the total force acting across the joint compare when standing on
one leg versus when running?: - total force across the joint is 2.5 times body weight when standing on
one leg and 5 times body weight when running
21. Where do femoral neck fractures anatomically occur?: - occur between trochanters
distally and head proximally
