Hip Dislocation

A hip dislocation is a common occurrence among the elderly. It consists of the separation of the femoral joint and the socket of the pelvis. There are different types of hip dislocations, depending on where the joint surface of the femur lies with respect to the tibia. It is essential to obtain specialized help as soon as possible in order to avoid further damage.

We can distinguish between two types of hip dislocation:

  • Anterior hip dislocation: the femoral head ends up shifting forward after dislocating from the acetabulum, that is, the concave articular portion of the pelvic surface.

  • Posterior hip dislocation: the femoral head dislocates behind the acetabulum. Posterior hip dislocation is the most common type by far, comprising of approximately 91% of all hip dislocations.

A hip dislocation usually occurs due to severe trauma, for example, from traffic accidents or high-impact activities.

The symptoms produced by hip dislocation are:

  • Pain around the hip.

  • Functional impotence: inability to rotate the leg when performing an external or internal rotation, depending on whether the dislocation is anterior or posterior.

  • Shortening of the limb and deformity in case of not receiving the necessary medical attention.

The diagnosis of a hip dislocation does not usually require special tests. It can be determined by two factors. First, the patient presents an intense pain around the hip and second, the leg is immobilized with an external rotation or internal rotation if it’s an anterior dislocation or posterior dislocation, respectively. However, it is advisable to perform an imaging test of the area. This way, the existence of a bone fracture associated with the dislocation is discarded before trying to manipulate it.

  • A radiological examination is sufficient to know the type of dislocation and to determine the appropriate treatment. If a radiography is not enough, it would be necessary to perform a CAT scan to check if there is displacement of the ligaments or fracture.

  • A CAT scan (computerized axial tomography) is an imaging technique that uses X-rays to obtain image cuts or anatomical sections, in this case the hip. In the diagnosis of hip dislocation, the simple and three-dimensional CAT scan are used.

To prevent further serious injury, treatment for a hip dislocation should be started as soon as possible. This treatment consists of repositioning the femoral head back to its natural position.

In general, re-insertion of the femoral head to the acetabulum of the hip is carried out with local anesthesia, in order to maintain the muscles relaxed. General anesthesia will be used as a last resort only. Once the joint is re-established, and X-ray should be performed to rule out fractures associated with the dislocation. Next, the leg is immobilized. The usual practice is to leave the leg immobilized with repose without getting out of bed.

Once the resting time has passed, rehabilitation exercises are essential. This is to recover the strength of weakened muscles from prolonged by immobilization.

A physiotherapist will suggest stretching and muscle toning exercises. If immediate medical attention is not available at the time of hip dislocation, appropriate first aid may be put into practice. Some steps for this are:

  • Immobilize the affected joint, absolute rest will be necessary to not aggravate the injury.

  • Apply ice to the hip to produce an analgesic effect.

  • Under no circumstances should you try to reposition the hip or administer any medication without consulting a doctor or professional.

Once these steps are followed it will be required to transfer the affected person to a medical center so the medical staff can carry out the necessary diagnosis and treatment.

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