Surgical Dislocation
Indications of surgical dislocation
Ganz surgical hip dislocation is useful in the management of severe hip diseases, providingan unobstructed view of the femoral head and acetabulum [3].
Available therapeutic options range from debridement to total hip arthroplasty.The technique may also be used in the treatment of some fractures of the femoral head and acetabulum and for complex revision hiparthroplasty.[1]
• Femoroacetabular Impingement (FAI) FAI is now widely recognized as a major cause of pain and early osteoarthritis of the hip in young adults [21]. It results from subtle structural abnormalities of the hip, including a reduced anterior femoral headـneck offset and/or an overgrowth of the anterosuperior acetabular rim. [22] …show more content…
Usually, the nonspherical part of the head-neck junctionis located anterosuperiorlyand is characterized by a reddishappearance of the cartilaginous surface. Sometimes, it takes some time until the reddening of the impingement cartilage becomes visible. In the periphery of such a nonspherical extension, a small fibrocyst may become visible, indicating the area of maximumimpingement. The location of these impingement cysts is mainly anterolateral and is always distal to the physis. Gentle removal of excess bone and recreation of a smooth femoral neck is preferred. To achieve this goal, small curved chiselsand spherical templates are used (Fig 25). Repetitive intraoperative assessment of femoral head sphericity (with templates) is performed. Excessive bone removal during the offset procedure should be avoided, although a resection of 30% of the neck diameter has been reported not to weaken the femoral neck. Furthermore, excessive resection may compromise the sealing function of the labrum. …show more content…
For proper management of displaced fractures, the joint should be exposed for accurate assessment of anatomic reduction, extra-articular placement of fixation screws, and complete removal offree fragments [26]. Precise restoration of the articular surface and joints congruity are the primary goals in treating displaced acetabular fractures with open reduction and internal fixation. Prognosis mainly depends on the accuracy of the
Ganz surgical hip dislocation is useful in the management of severe hip diseases, providingan unobstructed view of the femoral head and acetabulum [3].
Available therapeutic options range from debridement to total hip arthroplasty.The technique may also be used in the treatment of some fractures of the femoral head and acetabulum and for complex revision hiparthroplasty.[1]
• Femoroacetabular Impingement (FAI) FAI is now widely recognized as a major cause of pain and early osteoarthritis of the hip in young adults [21]. It results from subtle structural abnormalities of the hip, including a reduced anterior femoral headـneck offset and/or an overgrowth of the anterosuperior acetabular rim. [22] …show more content…
Usually, the nonspherical part of the head-neck junctionis located anterosuperiorlyand is characterized by a reddishappearance of the cartilaginous surface. Sometimes, it takes some time until the reddening of the impingement cartilage becomes visible. In the periphery of such a nonspherical extension, a small fibrocyst may become visible, indicating the area of maximumimpingement. The location of these impingement cysts is mainly anterolateral and is always distal to the physis. Gentle removal of excess bone and recreation of a smooth femoral neck is preferred. To achieve this goal, small curved chiselsand spherical templates are used (Fig 25). Repetitive intraoperative assessment of femoral head sphericity (with templates) is performed. Excessive bone removal during the offset procedure should be avoided, although a resection of 30% of the neck diameter has been reported not to weaken the femoral neck. Furthermore, excessive resection may compromise the sealing function of the labrum. …show more content…
For proper management of displaced fractures, the joint should be exposed for accurate assessment of anatomic reduction, extra-articular placement of fixation screws, and complete removal offree fragments [26]. Precise restoration of the articular surface and joints congruity are the primary goals in treating displaced acetabular fractures with open reduction and internal fixation. Prognosis mainly depends on the accuracy of the