CH 7 FEMUR and Pelvic Girdle

AP Axial Outlet: Pelvis; Taylor Method

-CR cephalad 20-35* for male

-CR cephalad 30-45* for female

-superior and inferior rami of pubis and body and ramus of ischium

AP axial inlet: Pelvis

-CR 408 degrees

-pelvic ring or inlet

-ischial spines fully shown

Posterior oblique: Pelvis-Acetabulum; Judet Method

-when centered downside acetabulum, the anterior rim of acetabulum and posterior column

-iliac wing shown

-when centered upside acetabulum, posterior rim of acetabulum and foramen

-ilioischial and iliopubic columns, aspects of pelvic ring

PA axial oblique: Acetabulum: Teufel Method

-when downside, CR 1in superior to level of greater trochanter, 2in lateral to midsagittal plane

-CR angled 12* cephalad

-centered downside acetabulum, the superoposterior wall of acetabulum is shown

oblique projection: acetabulum: False profile method

-pt in posterior oblique, with pelvis and thorax rotated 65* to wall bucky

-superolateral aspect of a acetabulum with femoral head centered

axiolateral (Inferosuperior) projection: Trauma: Hip and proximal femur: Danelius-Miller Method

-entire femoral head and neck,trochanter, acetabulum

-small part of lesser trochanter is visualized with inversion of affected leg

AP bilateral: Hips: Modified Cleaves Method

'“frog-leg”

-CR 3in below ASIS

-greater trochanter appears superimposed over femoral necks, appear foreshortened

Mediolateral: Hip and Proximal Femur: Modified Cleaves Method

-proper abduction (45*) of femur is shown by femoral neck in profile, superimposed by greater trochanter

-less abduction (20-30*) prevent superimposition of greater trochanter on femoral neck

femur

longest and strongest bone

angle of neck to shaft

125*

angle of longitudinal plane of proximal femur

10*

angle of anterior angle of head and neck

15*-20*

parallel

leg must be rotated 15-20 internally to place femoral neck ______ to IR for true AP of proximal femur

pelvic brim

greater or false pelvis

inferior to plane through pelvic brim

lesser or true pelvis

inlet or superior aperture

oblique plane by brim of pelvis

outlet or inferior aperture

defined by 2 ischial tuberosity and tip of coccyx

travels thru pelvic inlet—→ midcavity—→ outlet

baby head route thru birth canal

female pevlis

-wider, with ilia more flared an shallower from front to back

>90, obtuse angle

male pelvis

narrower, deeper or less flared with heart shaped pelvic inlet

<90 acute angle

sacroiliac joint

-synovial joint

-irregular gliding

symphysis pubis

-cartiliginous

-limited

union of acetabulum

-cartiliginous

-nonmoveable

hip joint

-synovial

-ball and socket

symphysis pubis

-interpubic disk of fibrocartilage relatively thick pad (thicker in females) capable of being compressed or partially displaced allowing limited movement of bones in case of pelvic trauma during childbirth

lesser trochanter

-internal rotation 15-20

lesser trochanter visible

external rotation 15-20

legg clave pertnel

-most common type of aseptic or ischemic necrosis

-5-10yo boy commonly seen

true

it is critical that the injured limb not be moved if leg is externally rotated