Pelvis, Hip, and Thigh Conditions

Chapter 14

Pelvis

SacrumCoccyxInnominate bone Ilium Ischium Pubis

Collectively protect the inner organs, bear weight, site of muscular attachments.

Sacroiliac Joints

Help bear weightProvide elasticity to pelvic ringIliac articulation covered in fibrocartilageSacral articulation covered in hyaline

Sacrococcygeal Joint

Usually a fused junctionUnited by a fibrocartilaginous disc

Pubic Symphysis

Cartilaginous joint with a disc of fibrocartilage called the interpubic discSpreadsCompressesRotates

Femur

Strongest and longest bone in the bodyWeakest link is the surgical neckAngles at 125° in the frontal plane

The hip joint

Acetabulum of the pelvis=socketHead of the femur=ballBoth surfaces covered in cartilageAcetabulum has a U-shaped cartilage structure known as the acetabular labrum

Hip joint capsule

Coxofemoral joint is large and looseCapsular fibers encircle the neck giving it great stability

Ligaments of the Hip Joint

Ligament of Bigelow AIIS-Femur

Pubofemoral ligamentIsciofemoralLigamentum teres Occurs within the joint

Inguinal ligament ASIS-pubic symphysis

Femoral Triangle

Inguinal ligamentSartoriusAdductor longusFemoral nerve, artery, and vein all exist within

Bursae

Iliopsoas – Iliopsoas and the articular capsuleTrochanteric – Greater trochanter and the gluteus maximusGluteofemoral – Gluteus maximus from the vastus lateralisIschial – Iscial tuberosity from the gluteus maximus

Q-Angle

Angle between the quads and the tibial tuberosityLines drawn between ASIS and patella and between patella and tibial tuberosityGenerally 13° in malesGenerally 18° in females

Muscles-Flexion

IliopsoasRectus femorisPectineusSartoriusTensor fasciae latae

Muscles-Extension

Gluteus maximusBiceps femorisSemitendinosusSemimembranosusAdductor magnus

Muscles-Abduction

Gluteus mediusGluteus minimusTensor fasciae lataeSartoriusPiriformis

Muscles-Adduction

PectineusAdductor brevisAdductor magnusAdductor longusGracilis

Muscles-Medial Rotation

Gluteus mediusGluteus minimusTensor fasciae latae

Muscles-Lateral Rotation

PiriformisObturator internusObturator externusSuperior gemelliIngerior gemelliQuadratus femorisGluteus maximus

Nerves

Lumbar plexus First four lumbar nerves

Sacral plexus L4-S4 nerves

Physical conditioning

Flexibility and strengthening of all overlapping muscle groups

Presentation guidelines

What is the injury? Show pictures, videos, demonstrations to help us

understand what is involved.

How does it happen? Again pictures, videos, demonstrations to show

how it happens.

How do you treat it acutely?What is the long term treatment?What special procedures help this problem? Surgeries, immobilization, rehabilitation,

mobilizations…

Contusions

Hip pointerQuadriceps contusionMyositis OssificansAcute compartment syndrome

Bursitis

Greater Trochanteric BursitisIliopsoas BursitisIschial BursitisSnapping Hip Syndrome

Sprains and Dislocations

Posterior-superior dislocation

Strains

Quadriceps StrainHamstrings StrainAdductor StrainGluteal StrainsPiriformis Syndrome

Vascular and Neural Disorders

Legg-Calvé-Perthes DiseaseVenous Disorders Thrombophlebitis Phlebothrombosis

Toxic SynovitisObturator Nerve Entrapment

Fractures

Avulsion fracturesSlipped capital femoral epiphysisStress fracturesOsteitis PubisDisplaced and Nondisplaced Pelvic fracturesSacral and Coccygeal fracturesFemoral Fractures