Hip joint

Hip joint - mnogochastny joint formed by the acetabulum pelvis and the head of the femur. Acetabulum is located at the junction of three bones: the top - iliac, bottom - sciatic, inside - the pubic. Joint bag hip joint is on the edge of the joint socket, switches on his thigh and attached to the front over mineralnoy line, therefore the most part of the femoral neck is in the cavity of the hip joint.hip the joint structure

Fig. 1. Right hip joint (front): 1-ilio-femoral ligament (outdoor unit); 2 - front-bottom ity Ilium; 3 - the location of the iliac-Grebeshkova bags; 4-thinned plot anterior joint capsule; 5 - pubic-femoral link; 6-locking membrane; 7-small skewer; 8 - mineralna line; 9-ilio-femoral ligament (interior Department).
Fig. 2. Frontal cut right hip joint: 1 - articular gap; 2 - a bond of the femoral head; 3 - articular bag.

In the bag of the joint woven chords: front - ilio-femoral bottom and inside - pubic-femoral, rear - sciatic-femoral, in the depths of the bag reinforced circular mapping. Inside the joint cavity lies a bunch of femoral head (Fig. 1 and 2). On the form of the hip joint is a spherical joints with a limited scale movements. Main motion in the hip joint - bending and straightening around the front axis; also possible, lead and rotate inwards and outwards. Bending produce muscles: iliopsoas, direct, muscle, wide bend the fascia of the thigh, tailoring, tender. The extension is carried out by: paliperidonesee, poluchila, the long head of the biceps and a large part of the buttocks, most leading muscles. Abstraction is due to the average gluteal and small gluteal muscles. Bringing possible while reducing the large, long, short lead, tender and Grebeshkova muscles. Turn inside average exercise gluteus (anterior) and small gluteal. Blood flow to the hip joint is carried out by branches of the lower buttock and locking of the arteries. Venous outflow from the hip joint is in a deep vein of the thigh and internal iliac vein. Lymphatic vessels penetrate into the pelvis through locking channel and flow in the internal iliac lymph nodes. Innervation of the hip joint is the branches of femoral, locking and sciatic nerve. The most frequent congenital diseases of the hip joint are dislocations (see), subluxations and dysplasia (see).
Deformation. If the axis of the femoral neck with the axis of the diaphysis hip forming an angle of less than 127 degrees deformation is called coxa vara. This pathology can be congenital, rachitic, youth (endocrine etiology), traumatic.
Coxa vara characterized by: claudication, LLD, limitation thigh and external rotation its positive symptom Trendelenburg - when standing on the leg, hip-buttock crease opposite side falls below a similar folds patient hand, a large spit is located above the line Rothera - Nelaton (see Rothera - Nelaton line), with bilateral coxa vara expressed lumbar lordosis (see). Radiographically determined by the decrease of cervico-diaphyseal angle. Treatment in the early stages in young children conservative: restorative therapy, unloading joint, light traction in the position of the thigh at an angle 50-60 degrees, the massage, medical gymnastics. Children over the age of 6-7 years showing surgery - osteotomy, reconstruction of the femoral neck.
Coxa valga - deformation of the hip joint, which is characterized by the increasing size of the cervico-diaphyseal angle over 130°, there is insufficient load on a limb (polio, dislocation, amputation stump). The diagnosis is usually made on an x-ray. Deformation does not cause functional disorders and requires no special treatment.
Damages of the hip joint are in the form of bruises, dislocations and fractures. Bruises (see) can be treated conservatively by common rules. Traumatic dislocations result from direct trauma, they occur very rarely. Victims should be immediately sent to the surgeon for reposition dislocation. Hip fractures are more common in the elderly and are divided into the medial, lateral and isolated fractures skewers. Treatment conservative - traction, the special position of the patient, Cocina cast (see Plaster technique). In case of unsuccessful conservative treatment shown operation - osteosynthesis (see).
Gunshot wounds of the hip joint can be: tangents, blind, and end-to-end. First aid: the imposition of an aseptic bandage and immobilization, at divisional the medical - surgical treatment of wounds. Gunshot wounds of the hip joint is often complicated by inflammation, requiring special treatment (see Coxit). Among benign tumors of the hip joint are more common: handsome, chondroplasty, and from malignant - chondrosarcoma. Treatment - operative.