Hip dislocation, Causes & Evaluation

M. N. Naderi , MD

Hip joint

• ball-and-socket joint

• Inherently stable joint

• Strong capsuloligamentous coverage

Hip dislocation

• high-energy trauma

• Post dx > ant dx

Role of force & hip position in Dx

Common Associated Fractures

• Pelvic ring fractures

• Femoral neck fractures

• Acetabular fractures

• Femoral head fractures

• Knee ligament injuries

• Spine injuries

• Femoral shaft fractures

Suspect these patient as multiple trauma patients

Classification

Signs & symptoms

• Pain

• Limb deformity

– Internal rotation in Post Dx

– External rotation in Ant dx

• Shortening of affected limb

Diagnosis of hip Dx may delayed due to more life-threatening associated injuries

Evaluation

• History & Physical exam

– palpation of all long bones and joints of extremity

– meticulous N/V exam

– Examination of spine and pelvis

• Imaging

–X-ray

• AP Pelvic x-ray

– CT Scan In true AP pelvic view the head will appear - larger than the contralateral if the dx is ant. - smaller the contralateral if dx is post.

Initial X-ray must be of good quality and inspected for associated injuries before reduction is attempted (In particular, associated femoral neck fractures )

Evaluation

• Imaging – X-ray

• AP Pelvic x-ray

–CT Scan • Usually indicated after CR

• detecting intraarticular fragments, femoral head fx, acetabular fx & joint incongruity

Evaluation

Pathoanatomy

• Femoral head injury

• Labral tear

• AVN

• DJD

Summary

• Emergency situation

• Early reduction

• Beware of associated injuries

• N/V evaluation

Thank you for attention