<p> ORTHOPAEDIC INJURIES</p><p>DISLOCATION OF THE HIP</p><p> USUALLY POSTERIOR</p><p> PRESENTS WITH LEG FLEXED, ADDUCTED AND SHORTENED</p><p> FEMORAL HEAD MAYBE PALPABLE IN THE BUTTOCK</p><p>TREATMENT</p><p> REDUCTION</p><p> SKIN TRACTION TO ALLOW CAPSULE TO HEAL</p><p> PROTECTED WEIGHT BEARING FRACTURE DISLOCATION OF THE HIP</p><p>NORMAL ACETABULUM HAS A STRONG ROOF</p><p> ILIO PUBIC COLUMN (ANTERIOR)  ILIO ISCHIAL COLUMN (POSTERIOR)</p><p>ACETABULAR FRACTURES ARE CLASSIFIED IN 4 GROUPS</p><p>JUDET FRACTURE GROUPS</p><p>1 FRACTURE OF THE POSTERIOR RIM 2 FRACTURE OF THE ILIO ISCHIAL COLUMN 3 TRANSVERSE FRACTURE 4 FRACTURE OF THE ILIO – PUBIC COLUMN</p><p>IN EACH CASE THE FEMORAL HEAD TENDS TO DISLOCATE</p><p>TREATMENT</p><p> INTERNAL FIXATION - DISPLACED  TRACTION EITHER LONG TERM OR PRIOR TO DEFINITIVE SURGERY FRACTURE OF THE FEMORAL NECK</p><p> SURGERY  SKIN TRACTION TO RELIEVE MUSCLE SPASM MAY BE APPROPRIATE</p><p>PERI-PROSTHETIC FRACTURES</p><p> SURGERY  TRACTION –LONG TERM UNTIL CALLUS FORMS  CHECK X-RAYS TO MONITOR PROGRESS  PROTECTED WEIGHT BEARING FRACTURES OF THE FEMORAL SHAFT</p><p> COMMON IN ALL AGE GROUPS  CAN OCCUR AT VARIOUS LEVELS OF THE SHAFT  OFTEN COMPOUND AND ASSOCIATED WITH OTHER INJURIES  BLOOD REPLACEMENT OFTEN NECESSARY</p><p>TREATMENT</p><p> AIM IS TO RESTORE LENGTH AND ALIGNMENT, ENCOURAGE EARLY UNION AND REHABILITATION</p><p> FIXED TRACTION – THOMAS SPLINT BEFORE SURGERY</p><p> INTERNAL FIXATION – INTER – MEDULLARY (IM) NAILING (ALLOWS EARLY MOBLISATION USUALLY TOUCH WEIGHT BEARING (TWB) INITIALLY THEN FULL WEIGHT BEARING (FWB)</p><p> EXTERNAL FIXATION FRACTURES OF THE LOWER SHAFT AND SUPRA – CONDYLAR FRACTURES</p><p> MOST COMMON IN THE ELDERLY  MORE DIFFICULT TO MANAGE (THE LOWER THE FRACTURE THE MORE THE FRAGMENT TENDS TO BE PULLED OUT OF ALIGNMENT)</p><p>TREATMENT</p><p> FIXED TRACTION – THOMAS SPLINT PRIOR TO DEFINITIVGE SURGERY OR LONG TERM</p><p> INTERNAL FIXATION – NAIL, SCREWS, PLATE (OSTEOPOROTIC BONE IN THE ELDERLY CAN MAKE THIS DIFFICULT)</p><p> PROTECTED WEIGHT BEARING GIRDLESTONE’S ARTHROPLASTY</p><p> EXCISION AT THE HEAD AND NECK OF FEMUR  FIBROUS TISSUE FORMS IN THE GAP BETWEEN THE ACETABULUM AND THE TROCHANTERS</p><p> ALLOWS MOVEMENT  PAIN FREE  RESULTANT SHORTENING</p><p>TREATMENT</p><p> TRACTION POST SURGERY SKIN/SKELETAL</p>