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Hip
Luxations
Hip
luxations typically result in craniodorsal displacement of the femoral
head relative to the acetabulum. Less than 50% of hip luxations
can be reduced via closed reduction and maintained in a reduced
position long enough for healing of the damaged soft tissues to
occur.
Surgery
is utilized when closed reduction fails to maintain hip reduction.A
toggle bolt repair is recommended to replace the function of the
round ligament. A toggle pin secured to a strand of monofilament
is placed medial to the acetabulum via a hole drilled through the
fovea capitis. A second hole is drilled from the attachment point
of the round ligament on the femoral head through the femoral neck
and exiting just distal to the trochanter. The strands of monofilament
are passed through this hole, the hip reduced and the strands tied
around a second toggle bolt along the lateral femoral cortex. Joint
capsule tears are reconstructed and the limb placed in a modified
ehmer sling PO.
Compared
to the other surgical techniques, the toggle bolt repair is reported
to provide the most stability to maintain hip reduction until surrounding
soft tissues heal.
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