Hip Joint Ligaments and Movements

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Questions and Answers

What hip flexion is required for ascending stairs?

67 degrees (correct)

124 degrees

104 degrees

80 degrees

Which exercise is recommended for femoral shaft fracture treated with intramedullary nail during Phase 1 (0-6 weeks)?

Active assisted hip abduction & adduction

Upper extremity exercise

Supine leg slides for flexion of hip & knee

Stationary bicycle WBAT (correct)

What is a discharge criteria for fractures of the upper end of the femur?

Able to ambulate 100 feet with assistive device

SLR in one direction

Standing hip adduction exercises

In & out of bathroom with assistance (correct)

Which activity should be done during Days 3-7 for fractures of the upper end of the femur?

Thomas stretch of hamstring Signup and view all the answers

What hip flexion is required for tying a shoe with foot on the floor?

67 degrees Signup and view all the answers

What is recommended 1-2 weeks after a femoral shaft fracture treated with intramedullary nail?

Begin weight bearing with 25kg Signup and view all the answers

What is the primary goal of successful treatment of lower extremity injuries?

All of the above Signup and view all the answers

Which phase of rehabilitation focuses on strengthening and endurance exercises, as well as progressive weight bearing?

Phase 2 (6 weeks to 3 months) Signup and view all the answers

Which type of subtrochanteric fracture involves the lesser trochanter being detached from the proximal fragment?

Type IB Signup and view all the answers

What is the primary purpose of Craig's Test?

To measure femoral anteversion or retroversion Signup and view all the answers

During which phase of rehabilitation is the focus on progression to full unsupported weight bearing, agility and endurance training, and reentry into work and recreational activities?

Phase 3 (3 to 6 months) Signup and view all the answers

Which type of trochanteric fracture involves a fracture between the greater and lesser trochanters?

Intertrochanteric fracture Signup and view all the answers

Which ligament elongates the most in the close-packed position of the hip joint?

Ischiofemoral ligament Signup and view all the answers

What is the normal range of the center-edge angle in the frontal plane of the hip joint?

22-42 degrees Signup and view all the answers

What is the significance of the acetabular anteversion angle?

It prevents anterior hip joint dislocation Signup and view all the answers

Which angle describes the relative twist between the femoral shaft and neck (anteversion)?

Torsion angle Signup and view all the answers

What is the normal range of the angle of inclination between the femoral neck and the medial side of the shaft?

150 degrees at birth, decreasing to 120 degrees in the elderly Signup and view all the answers

Which capsular pattern is associated with the close-packed position of the hip joint?

Flexion, abduction, medial rotation Signup and view all the answers

According to the rehabilitation protocol for open tibial shaft fractures treated with intramedullary nailing, what is the weight-bearing status during Phase 1 (0 to 6 weeks)?

Toe-touch weight-bearing (TTWB) Signup and view all the answers

Which exercise is recommended during Phase 1 (0 to 6 weeks) for open tibial shaft fractures treated with intramedullary nailing?

Short arc quadriceps exercises (open chain) Signup and view all the answers

According to the rehabilitation protocol for tibial shaft fractures treated with biplanar Ilizarov external fixation, which exercise is recommended during Phase 1 (0 to 6 weeks)?

Closed kinetic chain (CKC) exercises Signup and view all the answers

In the rehabilitation protocol for tibial shaft fractures treated with biplanar Ilizarov external fixation, what is the purpose of retro walking on a treadmill?

To improve ankle dorsiflexion range of motion Signup and view all the answers

During Phase 2 (6 weeks to 3 months) of the rehabilitation protocol for tibial shaft fractures treated with biplanar Ilizarov external fixation, what is recommended for addressing potential contractures?

Passive and active range of motion exercises Signup and view all the answers

According to the rehabilitation protocol, when can functional activities, agility training, and return to sports be initiated for open tibial shaft fractures treated with intramedullary nailing?

Phase 4 (after 6 months) Signup and view all the answers

Which of the following exercises is recommended during Phase 1 of rehabilitation for a stable tibial plateau fracture after internal fixation?

Prone hangs Signup and view all the answers

What is the recommended order for stair climbing during Phase 3 of rehabilitation for a stable tibial plateau fracture?

Up stairs with the sound limb first (S-A-C), followed by down stairs with the affected limb first (C-A-S) Signup and view all the answers

In the rehabilitation protocol for a tibial shaft fracture treated conservatively, at what stage is full weight-bearing (FWB) allowed?

After radiological union is confirmed Signup and view all the answers

Which of the following exercises is recommended during the 6 to 8 week period of rehabilitation for a tibial shaft fracture treated conservatively?

Both b and c Signup and view all the answers

Which of the following exercises is NOT recommended during Phase 2 of rehabilitation for a stable tibial plateau fracture after internal fixation?

Hamstring curls with weights at the ankle Signup and view all the answers

Which of the following injuries is NOT associated with a force to the lateral side of the knee?

Medial ligament rupture Signup and view all the answers

Study Notes

Hip Flexion and Mobility

Ascending stairs requires approximately 60-70 degrees of hip flexion.
Tying a shoe with the foot on the floor necessitates around 120 degrees of hip flexion.

Rehabilitation Phase 1 Exercises

For a femoral shaft fracture treated with an intramedullary nail, initial rehabilitation emphasizes isometric quadriceps and gluteal exercises.
For open tibial shaft fractures during Phase 1, suggested exercise includes non-weight bearing ankle pumps to maintain circulation.

Discharge and Recovery Criteria

Discharge criteria for upper femur fractures include the ability to perform safe transfers, adequate pain control, and independent mobility with assistive devices.
Days 3-7 after upper femur fractures should focus on bed mobility and gentle range of motion exercises.

Post-Fracture Recommendations

1-2 weeks following a femoral shaft fracture treated with an intramedullary nail, gentle active range of motion of the hip and knee can be initiated.
The primary goal of treating lower extremity injuries is to restore functional mobility.

Rehabilitation Phases Overview

Rehabilitation Phase 2 emphasizes strengthening, endurance exercises, and progressive weight-bearing activities.
During the final rehabilitation phase, focus shifts to full weight-bearing, agility, endurance training, and reintegration into daily activities.

Fracture Types and Classification

A subtrochanteric fracture involving the lesser trochanter indicates a more complex fracture pattern with a significant detachment.
Trochanteric fractures can be classified into basic types; those between the greater and lesser trochanters are a distinct category.

Hip Joint Anatomy and Testing

The ligament that elongates the most in the close-packed position of the hip joint is the iliofemoral ligament.
The normal center-edge angle in the frontal plane of the hip joint is between 25-39 degrees, significant for assessing hip stability.
The acetabular anteversion angle indicates the orientation of the acetabulum and influences hip joint biomechanics.
The angle of inclination typically ranges from 125-135 degrees, representing the relationship between the femoral neck and shaft.

Capsular Pattern and Weight-Bearing Status

The close-packed position of the hip joint is characterized by a capsular pattern of limited flexion, abduction, and internal rotation.
During Phase 1 of intramedullary nailing rehabilitation for open tibial shaft fractures, weight-bearing is typically non-weight bearing.

Exercise Recommendations for Tibial Shaft Fractures

For tibial shaft fractures treated with biplanar Ilizarov external fixation, retro walking on a treadmill serves to promote balance and coordination.
Addressing contractures during Phase 2 of rehabilitation may involve targeted stretching during physical therapy.
Functional activities and return to sports can commence approximately 3 months post-injury for intramedullary nailing cases.
During Phase 1 of stable tibial plateau fracture rehabilitation after internal fixation, recommended exercises include isometric exercises and gentle range of motion activities.

Stair Climbing and Rehabilitation Protocols

The recommended order for stair climbing during Phase 3 involves progressing from step ascent to descent, beginning with ascending leading with the stronger leg.
Full weight-bearing is typically permitted as rehabilitation progresses into later stages once adequate healing is evidenced.
In the late stages of rehabilitation (6-8 weeks), more challenging exercises can involve gradual impact activities depending on clinical assessment.

Activity Considerations

Certain exercises may be contraindicated during Phase 2 for a stable tibial plateau fracture after internal fixation, particularly high-impact or twisting motions.
Injuries not associated with lateral knee force might include certain types of medial collateral ligament injuries.

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Description

This quiz covers the ligaments of the hip joint such as the Iliofemoral ligament, Pubofemoral ligament, and Ischiofemoral ligament. It also discusses the close-packed position, capsular pattern, and articular congruence of the hip joint.