Fracture Management Joint by Joint Series Editors: Filippo Castoldi · Davide Edoardo Bonasia Lorenz Büchler Marius J.B. Keel Editors Fractures of the Hip Fracture Management Joint by Joint Series editors Filippo Castoldi Department of Orthopaedics CTO Hospital Turin Torino Italy Davide Edoardo Bonasia University of Torino AO Ordine Mauriziano Torino Italy This book series aims to provide orthopedic surgeons with up-to-date practical guidance on the assessment, preoperative work-up, and surgical management of intra-articular fractures involving different joints, including the shoulder, knee, hip, elbow, ankle, and wrist. Complex articular fractures are difficult to treat and sometimes require specific surgical skills appropriate to the involved joint. In addition, arthroscopic-assisted fracture reduction is increasing in popularity, but trauma surgeons are generally not trained in arthroscopic techniques. For these reasons, articular fractures are often referred by the trauma team to surgeons experienced in the management of injuries to the joint in question. Therefore, across the world it is becoming common for orthopedic surgeons to specialize in treating fractures of only one joint. This series is designed to fill a gap in the literature by presenting the shared experience of surgeons skilled in the use of arthroscopic and open techniques on individual joints. More information about this series at http://www.springer.com/series/13619 Lorenz Büchler • Marius J.B. Keel Editors Fractures of the Hip Editors Lorenz Büchler Marius J.B. Keel Department of Orthopaedic Surgery Trauma Center Hirslanden Kantonsspital Aarau Clinic Hirslanden Aarau Zürich Switzerland Switzerland ISSN 2364-3250 ISSN 2364-3269 (electronic) Fracture Management Joint by Joint ISBN 978-3-030-18837-5 ISBN 978-3-030-18838-2 (eBook) https://doi.org/10.1007/978-3-030-18838-2 © Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Foreword This book series aims to provide orthopaedic surgeons with up-to-date practi- cal guidance on the assessment, preoperative work-up and surgical manage- ment of intra-articular fractures involving different joints. Complex articular fractures are difficult to treat and sometimes require specific surgical skills appropriate to the involved joint. In addition, arthroscopic-assisted fracture reduction is increasing in popularity, but trauma surgeons are generally not trained in arthroscopic techniques. For these reasons, articular fractures are often referred by the trauma team to surgeons experienced in the management of injuries to the joint in question. Therefore, across the world it is becoming common for orthopaedic surgeons to specialize in treating fractures of only one joint. This series is designed to fill a gap in the literature by presenting the shared experience of surgeons skilled in the use of arthroscopic and open techniques on individual joints. In this specific book, Dr. Büchler and Dr. Keel, world renowned experts in this field, developed a comprehensive table of contents regarding hip frac- tures. Surgical anatomy and relevant radiology are described together with different surgical approaches, including those that many surgeons are not very familiar with. Then, acetabulum and proximal femur fracture manage- ment is described in detail including conservative and surgical treatments. The management (open and arthroscopic) of some common complications (malunion, nonunion, loose bodies, etc.) is included as well. Experts from all over the world were invited to participate in this project. The result is a practi- cal reference guide for the hip surgeon, trauma surgeons and orthopaedic resident approaching simple and complex fractures around the hip. Torino, Italy Filippo Castoldi Torino, Italy Davide Edoardo Bonasia v Preface The series “Fracture Management Joint by Joint”, to which this volume belongs, has introduced a new concept of up-to-date literature emphasizing the importance to assess articular fractures in the context of the entire ana- tomical region. Thus, the book is intended to be useful to the specialized orthopaedic surgeon and general trauma surgeon alike. A wide variety of approaches and surgical techniques are used to treat hip fractures, and the selection of the best therapy is challenging. The purpose of this book is to support the reader towards a broad understanding of the trau- matized hip, including anatomy, biomechanics, diagnosis and surgical treat- ment. As a result, the surgeon should be confident to choose the appropriate treatment for a specific fracture in an individual patient, may this be conser- vative, by osteosynthesis or through total hip arthroplasty. We have assembled a group of renowned trauma surgeons from around the world to present a comprehensive, up-to-date overview over their respective field of expertise. The book is divided into three sections: Principles, includ- ing anatomy, biomechanics, radiology and initial management, chapters on surgical approaches and chapters on specific fracture types, pathological frac- tures and complications. It has been a tremendous pleasure to interact with such an excellent fac- ulty, and we thank the authors for having dedicated their time and expertise. We have learned a lot ourselves. Also, we would like to thank the editorial staff at Springer. Without their great assistance and support, this project would not have been possible. We hope that the entire series, and this book in particular, will serve as a valuable tool in the reader’s clinical practice. Bern, Switzerland Lorenz Büchler Zürich, Switzerland Marius J.B. Keel vii Contents 1 Anatomy of the Hip Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Michael Wyatt, Carl Freeman, and Martin Beck 2 Radiology of the Hip Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Florian Schmaranzer, Till D. Lerch, Inga A. S. Todorski, Moritz Tannast, and Simon Steppacher 3 Initial Management of Hip Fractures Prior to Surgical Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Mark Haimes and Michael Blankstein 4 Ilio-Inguinal Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Lorenz Büchler and Helen Anwander 5 Anterior Approaches to the Acetabulum . . . . . . . . . . . . . . . . . . . 53 Claude H. Sagi 6 The Pararectus Approach to the Acetabulum . . . . . . . . . . . . . . . 69 Johannes D. Bastian and Marius J.B. Keel 7 Lateral Approach to the Pelvis and Hip . . . . . . . . . . . . . . . . . . . . 77 Joseph M. Schwab, Chad Beck, and Klaus A. Siebenrock 8 Extended Iliofemoral and Combined Approaches . . . . . . . . . . . . 89 Marius J.B. Keel 9 Traumatic Hip Dislocations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Mark Rickman and Lorenz Büchler 10 Acetabular Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Ippokratis Pountos and Peter V. Giannoudis 11 Pipkin Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Benedikt J. Braun, Jörg H. Holstein, and Tim Pohlemann 12 Femoral Neck Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Govind S. Chauhan, Mehool Acharya, and Tim J. S. Chesser 13 Pathologic Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Frank M. Klenke, Attila Kollár, and Christophe Kurze ix x Contents 14 Acetabular and Femoral Neck Fracture Nonunion and Malunion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Robert C. Jacobs, Craig S. Bartlett, and Michael Blankstein 15 The Use of Hip Arthroscopy in Trauma of the Hip . . . . . . . . . . . 189 Alessandro Aprato, Federico Bertolo, Alessandro Bistolfi, Luigi Sabatini, and Alessandro Massè 1 Anatomy of the Hip Joint Michael Wyatt, Carl Freeman, and Martin Beck Abstract to not only understand hip pathology but also to The normal hip is often described as a synovial intervene safely with procedures such as surgi- ball and socket joint but this hardly does it jus- cal hip dislocations. In this chapter we will tice. The hip represents a remarkable coexis- explore both acetabulum and proximal femur tence of stability married to versatility in from their development to final morphology. motion. Furthermore this biomechanical phe- We shall delve into what is known about the nomenon is built to sustain the demands of a labrum and other articular structures. Finally lifetime and today such demands are ever we shall scrutinize the complex blood supply to increasing. In broad terms the bony anatomy the hip for this is paramount to the prognosis of with concave socket articulating with the femo- non-a rthroplasty treatment of intra-articular hip ral head creates an incredibly stable joint chal- fractures and preventing complications. lenged only in the most part by high-e nergy trauma. Its complex intra-articular structures Keywords and lubrication system create a mobile and Hip · Anatomy · Embryology · Surface durable couple, the secrets of which have not anatomy · Blood supply yet fully been elucidated. The intricate arterial anastomoses supplying the joint have only been revealed in recent years. The application of this anatomical knowledge has permitted surgeons 1.1 Landmarks of the Hip Joint The most readily identifiable landmarks for the hip and acetabulum are the greater trochanter and M. Wyatt (*) the anterior superior iliac spine (ASIS). The ASIS Department of Trauma and Orthopaedics, MidCentral District Health Board, Palmerston North Hospital and lies superiorly and just laterally to the acetabu- Massey University, Palmerston North, Manawatu, lum in the coronal plane and indicates the loca- New Zealand tion of the anterior column, the anterior wall, and e-mail: [email protected] the iliac crest. The lateral femoral cutaneous C. Freeman nerve lies between two and four centimeters Jacksonville Orthopaedic Institute, medial from the ASIS [1]. The anterior inferior Jacksonville, FL, USA iliac spine (AIIS) lies directly anterior and supe- M. Beck rior to the acetabulum (Fig. 1.1). The iliopectin- Clinic for Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Luzern, Switzerland eal eminence, which develops from the pubic © Springer Nature Switzerland AG 2019 1 L. Büchler, M. J.B. Keel (eds.), Fractures of the Hip, Fracture Management Joint by Joint, https://doi.org/10.1007/978-3-030-18838-2_1