中医骨科学外文版 (32).ppt

Anatomy of HipThe hip joint is the largest and most typical ball and socket joint ulna of the human body with the deepest glenoid fossa.It is composed of acetabulum and femoral head Its main functions are weight-bearing and multi-directional movement,absorption and reduction of concussion,and it plays a leverage role in body activities.Anatomy of HipAcetabulum The body of the ilium constitutes the acetabulum top,the body of ischium constitutes the posterior wall and bottom of acetabulum,the body of the pubic bone constitutes the anterior wall of acetabulum.The three parts jointly constitute the acetabulum Anatomy of HipThe femoral head is round with a small fossa slightly posterior to the top,which is the attachment of the femoral head ligament.The femoral neck slightly tilts forward,the middle is thin,with a greater trochanter on the lateral side,and a lesser trochanter on the medial side The calcar femorale is medial and posterior to junction of femoral shaft and neck.The femoral load is eccentric,while calcar femorale is the point of strength of femur.Anatomy of HipCollodiaphyseal angle The angle between the longitudinal axis of the femoral shaft and the axis of the femoral neck is the collodiaphyseal angle of femur.Normal range:110-140,with an average of 128,132 for males,127 for females,and 150-160 for children.The angle decreases with age.Anatomy of HipAnteversion angle or torsion angle:The central axis of femoral neck forms an angle with the line connecting the midpoints of femoral condyles,which is called anteversion angle or torsion angle.The normal range is 1215 Hip Examination Patricks test:The patient is in the supine position,the healthy limb is straightened,the affected limb is bent,the lateral malleolus of the affected limb is placed on the opposite knee joint,and both lower limbs are in the shape of number 4.The examiner will support the opposite anterior superior iliac spine on the front with one hand,and put the other hand on the medial side of the curved knee joint,and then press down with both hands to make the knee as close as possible to the bed.The test is positive in case of pain,indicating sacroiliac joint strain and rheumatoid arthritis.Hip Examination Hip extension test:The patient is in prone position and bends his knees to 90.The examiner presses the affected lower iliac joint with one hand and lifts the affected calf with the other hand.If it can induce pain in the sacroiliac joint,it is positive,indicating sacroiliac joint strain and rheumatoid arthritis.Hip Examination Bedside test:The patient lies in supine position,and the affected side is close to the bedside,so that the buttocks can protrude slightly and the thighs can hang down.The lower limbs of the opposite side bend their hips and knees,and hold their hands in front of their knees.The examiner supports the iliac crest with one hand,fixes the pelvis,and presses the thigh hanging from the bed toward the ground with the other hand.If it can induce pain at the sacroiliac joint,it is positive.