Avascular Necrosis, Blood Supply Femoral Head- Everything You Need To Know - Dr. Nabil Ebraheim скачать в хорошем качестве

Avascular Necrosis, Blood Supply Femoral Head- Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the conditions affecting the blood supply of the femoral head. Where is the important blood supply of the femoral neck located? On the postero-superior aspect of the femoral neck. The main blood supply for the weight-bearing dome of the femoral head is the medial femoral circumflex artery (lateral epiphyseal artery). Using an awl at the piriformis fossa in children requiring intramedullary fixation of their femur fracture may endanger the blood supply and cause avascular necrosis of the femoral neck. Avascular necrosis is death of a segment of bone. High energy neck fracture •Vertical fracture of the femoral neck that has vertical obliquity of 70 or more degrees. Has a high rate of nonunion and avascular necrosis. •Displacement of the femoral neck fracture disrupts the blood supply (kinks the retinacualr vessels). Pressure from the intracapsular hematoma may affect the blood supply. Clinical picture •Hip is in flexion and external rotation •Surgical emergency in young adults to unkink the vessels. Treatment •Obtain anatomic reduction in young adults. •Open reduction if closed reduction is not possible, use Watson Jones approach between the gluteus medius and the tensor fascia latae. •Follow the patient with an MRI to evaluate AVN. •If the patient develops nonunion and the head is viable, treat the nonunion by valgus intertrochanteric osteotomy. Hip dislocations Posterior dislocation is common. Anterior dislocation is rare. Treatment Emergent closed reduction within 6 hours. Assess hip stability post-reduction. Other factors associated with hip osteonecrosis •Corticosteroid use •Alcohol abuse •Hemoglobinopathy •Coagulopathy •Gaucher disease •Pregnancy (rare). Idiopathic AVN Nontraumatic AVN of the femoral head is located anterolateral. Become a friend on facebook:   / drebraheim   Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC