Contents
- Etiology
- Anterior Hip Dislocation (10-15%)
- Posterior Hip Dislocation (85-90%)
- Central Hip Dislocation
- Complications for All Hip Dislocations
Reduce hip dislocations ASAP (ideally within 6 hours) to reduced risk of AVN of the femoral head.
Etiology
- mechanism is usually a high-energy trauma, therefore pts. often have other life threatening injuries
Anterior Hip Dislocation (10-15%)
- mechanism: posteriorly directed blow to knee with hip widely abducted
- clinical features: shortened, abducted, externally rotated limb
- treatment
-closed reduction under GA
-post-reduction CT to assess joint congruity
Posterior Hip Dislocation (85-90%)
- mechanism: severe force to knee with hip flexed and adducted (e.g. knee into dashboard in motor vehicle accident (MVA))
- clinical features: shortened, adducted and internally rotated limb
- treatment
-closed reduction under GA (longitudinal traction ? adduction of hip ? IR)
-ORIF if unstable, intra-articular fragments or posterior wall fracture
-post-reduction CT to assess joint congruity and fractures
-if reduction is unstable ? traction x 4-6 weeks
 |
PEARL
Reduction of the Posteriorly Dislocated Hip longitudinal traction -> adduction of the hip -> internal rotation |
Central Hip Dislocation
- mechanism: traumatic injury where femoral head is pushed through acetabulum toward pelvic cavity
Complications for All Hip Dislocations
- post-traumatic arthritis
- AVN
- fracture of femoral shaft or neck
- sciatic nerve palsy in 25% (10% permanent)
- heterotopic ossification (HO)
- damage to femoral head