HIP DISLOCATION (FEMUR DISLOCATION)

HIP DISLOCATION (FEMUR DISLOCATION)

INTRODUCTION:

     A traumatic hip dislocation occurs when the head of the thighbone (femur) is forced out of its socket in the hip bone (pelvis). It typically takes a major force to dislocate the hip. Car collisions and falls from significant heights are common causes and, as a result, other injuries like broken bones often occur with the dislocation. A hip dislocation is a serious medical emergency. Immediate treatment is necessary.

·         Epidemiology

Ø  rare, but high incidence of associated injuries 

Ø  mechanism is usually young patients with high energy trauma

·         Hip joint inherently stable due to

Ø  bony anatomy

Ø  soft tissue constraints

ANATOMY:

           

CLASSIFICATION:

Ø  Simple: dislocation without associated fracture.

Ø  Complex: dislocation associated with fracture of acetabulum or proximal fever.

v  Anatomic Classification:

Ø  Posterior Dislocation: (90%)

Ø  Anterior Dislocation: (Rare)

SIGNS AND SYMPTOMS:

        

·         Acute pain/ severe pain.

·         Inability to walk and make few steps.

·         Deformity

·         If there is any nerve damage (SCIATIC NERVE).

Patient will have:

o   Numbness over the foot and ankle.

o   Foot drop.

o   Unable to do dorsi-flexion of foot.

DIAGNOSIS:

Ø  X-ray:

Ø  CT-Scan:

  

Ø  MRI:

o   Useful to evaluate labrum, cartilage and femoral head vascularity.

TREATMENT:

Ø  NON-OPERATIVE:

o   Closed Reduction: Reduction should be done within 6-8 hours.

Ø  OPERATIVE:

o   Open Reduction with or without removal of incarcerated fragments.

o   Open Reduction Internal Fixation.

COMPLICATION:

Ø  Osteonecrosis/Avascular Necrosis. (5-40%)

Ø  Sciatic Nerve injury. (8-20%)

Ø  Post-traumatic Arthritis. (Up to 20%)

Ø  Recurrent Dislocation (Less than 2%)

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