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Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, [1] especially in the femur and tibial bones, but can also occur genetically at birth.
Hip dysplasia is a congenital condition in which the hip is deformed in a way that decreases the congruency between the head of the femur and the acetabulum of the pelvis. [22] Bony congruence is a stabilizing factor to the hip joint, so the decrease in this conferred by hip dysplasia makes one more susceptible to dislocation. [22]
X-ray of Femoral Osteotomy hardware to correct femoral rotation caused by hip dysplasia. X-ray of the right hip in female patient in early thirties. Two main types of osteotomies are used in the correction of hip dysplasias and deformities to improve alignment/interaction of acetabulum – (socket) – and femoral head – (ball), innominate osteotomies and femoral osteotomies.
As the hip flexes, the tension in the ligament is reduced and the amount of possible rotations in the hip joint is increased, which permits the pelvis to tilt backwards into its sitting angle. Lateral rotation and adduction in the hip joint is controlled by the strong transversal part, while the descending part limits medial rotation. [4]
FABER or Patrick test - To identify if pain may come from the sacroiliac joint during flexion, abduction, and external rotation, the clinician externally rotates the hip while the patient lies supine. Then, downward pressure is applied to the medial knee stressing both the hip and sacroiliac joint. [1] [2] [4]
If you can get comfortable here, then bend right knee and slowly rotate hip in and out. Your psoas will move back and forth across the ball. Continue this for 1-2 minutes. Switch sides and repeat.