- See:
-
Avascular Necrosis after Hip Dislocation:
-
Closed Reduction
-
Total Hip Replacement Dislocation
- Discussion:
- hip dislocations are typically caused by high-energy trauma, usually from motor-vehicle accidents.
- they occur most frequently in young patients;
-
types of dislocations:
-
anterior dislocation
-
central acetabular fracture dislocations
-
posterior hip dislocations
-
associated injuries:
- Clinical Findings:
- in general, patients w/ posterior hip dislocations will have internal rotation of the hip, where as patients w/ anterior dislocations
will have external rotation of the hip;
- if this is not the case, be suspicious for femoral neck or shaft frx, or an ipsilateral knee dislocation;
- Radiographic Evaluation of Hip Dislocation::
- AP of the Hip;
-
pelvic series radiographs (
AP,
inlet and outlet);
-
acetabular series radiographs (
Judet views);
- radiograph of the femur and knee;
- w/
posterior dislocations, the head will migrate superiorly;
- w/
anterior dislocations, the head will migrate inferiorly or medially;
- because the trauma cassett is placed underneath the buttocks, the femoral head will appear small w/ posterior dislocations and will
appear large w/ anterior dislocations;
- Complications:
- Chondrolysis
- Coxarthrosis
-
Heterotopic Ossification
-
AVN after Hip Dislocation:
-
Sciatic Nerve Injury:
- approx 10% w/ dislocation but may be as high as 35% in posterior acetabular fracture;
- iatrogenic injury may be the result of laceration, penetration by drill bits, excessive traction by retractors, or prolonged extension of the ipsilateral knee;
- it appears that injuries of peroneal division of sciatic nerve have a worse prognosis than injuries of the tibial division;
- Coxa Magna
- may occur in upto 50% of children who sustain hip dislocation;
Irreducible traumatic dislocations of the hip.
Treatment of unreduced traumatic posterior dislocations of the hip.
Fractures of the femoral head.
Reduction of posterior dislocation of the hip in the prone position.
Herwig-Kempers A.
Veraart BE.
Journal of Bone & Joint Surgery - British Volume. 75(2):328,1993 Mar.
Recurrent Dislocation of a Hip With a Labral Lesion: Treatment with a Modified Bankart-Type Repair.
Case Report.
Traumatic Posterior Fracture-Dislocation of the Hip with Fracture of the Femoral Head or Neck, or Both.
Coxarthrosis Following Traumatic Posterior Dislocation of the Hip.
Traumatic Posterior Fracture-Dislocation of the Hip with Fracture of the Femoral Head or Neck, or Both.
Postoperative total hip prosthetic femoral head dislocations. Incidence, etiologic factors, and management.
Isolated traumatic dislocation of the hip. Long-term results in 50 patients.
Posterior fracture dislocation of the hip with fractures of the femoral head.
Fate of bone grafts in acetabular roof reconstructions assessed by roentgenography and scintigraphy.
Irreducible fracture dislocation of the hip: a severe injury with a poor prognosis.
MD McKee et al.
J. Orthop Trauma.
Vol 12. No 4. p 223-229.
Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis.
Hip Arthroscopy to Remove Loose Bodies After Traumatic Dislocation.
