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Hip Dislocation

(Dislocated Hip; Dislocation, Hip)

Definition

A hip dislocation occurs when the ball of the thighbone moves out of place within the socket of the pelvic bone. This ball and socket form the hip joint.
The Hip Joint
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Causes

Hip dislocations are relatively rare and severe injuries. They are often associated with femur or pelvic fractures . A normal hip joint is stable and strong. A hip dislocation can only occur when a strong force is applied to the hip joint.
  • Severe falls, especially from heights
  • Motor vehicle accidents
  • Sports injuries, especially from football, rugby, skiing, and snowboarding

Risk Factors

Factors that can increase your chance of developing this condition include:
  • Prior hip replacement surgery
  • Abnormal hip joint
  • Severe falls, especially from heights
  • Motor vehicle accidents
  • Sports injuries, especially from football, rugby, skiing, and snowboarding
  • High risk behaviors, such as excessive alcohol use
  • Poor muscle control or weakness leading to falls

Symptoms

Symptoms include:
  • Severe pain in the hip, especially when attempting to move the leg
  • Pain that spreads to the legs, knees, and back
  • Leg on the affected side appears shorter than the other leg
  • Hip joint appears deformed
  • Pain or numbness along the back of thighs if injury presses on the sciatic nerve
  • Being unable to walk

Diagnosis

The doctor will ask about your symptoms and how the injury occurred. An exam of your your hip and leg will be done.
Images may be taken of your bones. This can be done with:
  • X-ray
  • Computed tomography (CT) scan —to look for loose bodies and fragments impeding reduction, and acetabular fractures
  • MRI—to evaluate ligament, cartilage and other soft-tissue injury

Treatment

Treatments include:

Closed Reduction

The doctor will manipulate the thigh and leg. This is to try to put the ball of the femur back into the hip socket. You may be given medications to relax, such as:

Open Reduction

In some cases, surgery is needed. Open reduction is often done if:
  • Closed reduction is unsuccessful
  • Bony fragments or soft tissue remain in the joint space
  • The joint remains unstable
  • The thigh or pelvic bones are also broken

Physical Activity

When you are ready, you should begin range of motion exercises to keep your hip joint flexible as recommended by your doctor.
Your doctor will refer you to a physical therapist to help you with your rehabilitation.

Prevention

There are no guidelines for preventing hip dislocation. Most come from car accidents or sports injuries. To reduce your risk, take the following steps:
  • Wear your seat belt in the car.
  • Obey speed limits and other traffic laws.
  • Do not drink and drive.
  • Wear proper safety equipment for sports.
  • Use safety precautions to prevent falls when working at heights.
  • Follow your doctors directions to manage chronic conditions that involve the joints.

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Canale ST, Campbell WC. Campbell's Operative Orthopaedics . 9th ed. St. Louis, MO: Mosby, Inc; 1998.

Roberts JR, Hedges JR, Bell MH. Clinical Procedures in Emergency Medicine . 3rd ed. Chicago, IL: WB Saunders Company; 1998.

Rosen P, et al. Emergency Medicine: Concepts and Clinical Practice . 4th ed. St. Louis, MO: Mosby-Year Book, Inc; 1998.

Revision Information

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