The Hip: Preservation, Replacement and Revision

Radiographic Evaluation of Hip Dislocation



- See: Radiology of Hip

- Pre Reduction Evaluation:
    - frx-dislocation usually confirmed by a single AP x-ray;
    - rule out: assoc acetabular, femoral head, or femoral neck frx;
         - these must be recognized prior to reduction;
         - femoral head: for assoc frx;
         - acetabulum: presence, size, and location of fragments;
              - Judet View
              - evaluate post. wall frx ( > 40% is Unstable)
              - injured side is elevated to 45 deg w/ pt supine, to demonstrate posterior acetabular rim in profile;
         - femoral neck: r/o non-displaced frx that might displace when Closed Reduction is attempted;
    - CT scan should be performed in all cases to identify intra articular fragments or associated fractures such as femoral head fractures;
         - CT would be indicated prior to reduction if radiographs show a posterior wall frx ( > 40% implies Unstable frx-dislocation);

- Post Reduction Evaluation:
    - need to assess stability following either closed or open reduction;
    - CT can assist in assessment of stability after reduction of posterior dislocations of the hip;
         - stability is inversely proportional to the size of the posterior acetabular fragment;
         - fragments involving < 25% of acetabular wall do not affect hip stability, while those involving > 40% result in instability



Changes on magnetic resonance images after traumatic hip dislocation.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, September 19, 2012 11:37 am