Difference between revisions of "X-ray of Hansson pins"
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| + | Hansson pins are also called LIH pins after its developer Lars Ingvar Hansson, and are widely used in Sweden and the UK.<ref>{{cite journal|title=Lars Ingvar Hansson 1937–1987|journal=Acta Orthopaedica Scandinavica|volume=58|issue=6|year=2009|pages=685–692|issn=0001-6470|doi=10.3109/17453678709146515}}</ref> | ||
==Planning== | ==Planning== | ||
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==Post-operative evaluation== | ==Post-operative evaluation== | ||
[[File:X-ray of Hansson pins with contact points.jpg|thumb|Support points]] | [[File:X-ray of Hansson pins with contact points.jpg|thumb|Support points]] | ||
| − | The pins should be at least 2 cm apart on frontal projection, and have <10° angle compared to each other. | + | |
| − | === | + | ===Pin positions=== |
| − | For proper support, both pins should have support by the subchondral plate and the lateral cortex. In addition, the middle of the inferior pin should be supported by the medial cortex, and the middle of the posterior pin should have support from the medial cortex, with less than <5 mm distance from subchondral bone.<ref name=ToplicMellner | + | Pin position evaluation is generally not mandatory for radiologists unless specifically requested by the orthopedic surgeon. |
| + | |||
| + | The pins should be at least 2 cm apart on frontal projection, and have <10° angle compared to each other.<ref name=ToplicMellner>{{cite web|url=http://www.ortobas.se/lih-spikning/|title=LIH-spikning (Hansson Pin)|author=Marsel Toplić, Carl Mellner|website=ortobas.se}}</ref> The inferior pin should be inserted at the level of the minor trochanter (insertion below it increases the risk of subsequent subtrochanteric fracture).<ref name=ToplicMellner/> | ||
| + | |||
| + | For proper support, both pins should have support by the subchondral plate and the lateral cortex. In addition, the middle of the inferior pin should be supported by the medial cortex, and the middle of the posterior pin should have support from the medial cortex, with less than <5 mm distance from subchondral bone.<ref name=ToplicMellner/> | ||
===Fracture alignment=== | ===Fracture alignment=== | ||
"No misalignment" means:<ref name=ToplicMellner/> | "No misalignment" means:<ref name=ToplicMellner/> | ||
*Dislocation of less than 2 mm | *Dislocation of less than 2 mm | ||
| − | *0-15° valgus | + | *0-15° valgus angle on frontal projection |
| − | *Dorsal tilt of <10° | + | *Dorsal tilt of <10° on lateral projection |
| + | |||
| + | ===Leg length discrepancy=== | ||
| + | <gallery widths="330" heights="150"> | ||
| + | File:Leg length discrepancy after hip replacement.jpg|''Leg length discrepancy'' after Hansson pins is calculated similarly to in [[X-ray of hip prostheses]] (pictured), calculated as the vertical distance between the middle of the minor trochanters, using the acetabular tear drops<ref name=Vanrusselt2015/> or the transischial line<ref name=Watt/> as references for the horizontal plane. A discrepancy of up to 1 cm is generally tolerated.<ref name=Vanrusselt2015>{{cite journal|last1=Vanrusselt|first1=Jan|last2=Vansevenant|first2=Milan|last3=Vanderschueren|first3=Geert|last4=Vanhoenacker|first4=Filip|title=Postoperative radiograph of the hip arthroplasty: what the radiologist should know|journal=Insights into Imaging|volume=6|issue=6|year=2015|pages=591–600|issn=1869-4101|doi=10.1007/s13244-015-0438-5|pmid=26487647}}</ref><ref name=Watt>{{cite web|url=http://www.radiologyassistant.nl/en/p431c8258e7ac3/hip-arthroplasty.html|title=Hip - Arthroplasty -Normal and abnormal imaging findings|author=Iain Watt, Susanne Boldrik, Evert van Langelaan and Robin Smithuis|website=Radiology Assistant|accessdate=2017-05-21}}</ref> | ||
| + | </gallery> | ||
==Report== | ==Report== | ||
| − | Example: Inserted Hansson pins have proper positions. No fracture misalignment. | + | Example: |
| − | + | <br>''Inserted Hansson pins'' (and if evaluated, they) ''have proper positions.'' | |
| + | <br>''No fracture misalignment or significant leg length discrepancy.'' | ||
| + | {{Fracture reporting}} | ||
{{Bottom}} | {{Bottom}} | ||
Latest revision as of 09:50, 30 July 2019
Author:
Mikael Häggström [notes 1]
Hansson pins are also called LIH pins after its developer Lars Ingvar Hansson, and are widely used in Sweden and the UK.[1]
Contents
Planning
Frontal and lateral projections.
Post-operative evaluation
Pin positions
Pin position evaluation is generally not mandatory for radiologists unless specifically requested by the orthopedic surgeon.
The pins should be at least 2 cm apart on frontal projection, and have <10° angle compared to each other.[2] The inferior pin should be inserted at the level of the minor trochanter (insertion below it increases the risk of subsequent subtrochanteric fracture).[2]
For proper support, both pins should have support by the subchondral plate and the lateral cortex. In addition, the middle of the inferior pin should be supported by the medial cortex, and the middle of the posterior pin should have support from the medial cortex, with less than <5 mm distance from subchondral bone.[2]
Fracture alignment
"No misalignment" means:[2]
- Dislocation of less than 2 mm
- 0-15° valgus angle on frontal projection
- Dorsal tilt of <10° on lateral projection
Leg length discrepancy
- Leg length discrepancy after hip replacement.jpg
Leg length discrepancy after Hansson pins is calculated similarly to in X-ray of hip prostheses (pictured), calculated as the vertical distance between the middle of the minor trochanters, using the acetabular tear drops[3] or the transischial line[4] as references for the horizontal plane. A discrepancy of up to 1 cm is generally tolerated.[3][4]
Report
Example:
Inserted Hansson pins (and if evaluated, they) have proper positions.
No fracture misalignment or significant leg length discrepancy.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ "Lars Ingvar Hansson 1937–1987 ". Acta Orthopaedica Scandinavica 58 (6): 685–692. 2009. doi:. ISSN 0001-6470.
- ↑ 2.0 2.1 2.2 2.3 Marsel Toplić, Carl Mellner. LIH-spikning (Hansson Pin). ortobas.se.
- ↑ 3.0 3.1 Vanrusselt, Jan; Vansevenant, Milan; Vanderschueren, Geert; Vanhoenacker, Filip (2015). "Postoperative radiograph of the hip arthroplasty: what the radiologist should know ". Insights into Imaging 6 (6): 591–600. doi:. ISSN 1869-4101. PMID 26487647.
- ↑ 4.0 4.1 Iain Watt, Susanne Boldrik, Evert van Langelaan and Robin Smithuis. Hip - Arthroplasty -Normal and abnormal imaging findings. Radiology Assistant. Retrieved on 2017-05-21.
