Hip Dislocation, Traumatic
- Displacement of the femoral head from the acetabulum
- True orthopedic emergency
Etiology and Pathophysiology
- Protective factors: depth of acetabulum, surrounding labrum, thick joint capsule, and strong muscular support
- Posterior dislocations occur when the knee is flexed and the hip is adducted and flexed.
- Anterior dislocations occur when the hip is abducted and externally rotated.
- Anterior dislocations can occur in sporting activities such as American football, rugby, skiing, bicycling, basketball, and gymnastics (4)[C].
- The force required to cause a dislocation increases with age. Minor trauma may produce dislocation before age 10 years. Higher energy trauma is typical after age 12 years (5)[C].
- The femoral epiphysis may be injured during dislocation, complicating long-term prognosis. Surgical reduction is necessary (5)[C].
- Immobilization postreduction in a spica cast or bed rest for 3 to 4 weeks is recommended for children age <10 years (5)[C].
- Up to 25% of pediatric hip dislocations have a labral injury or loose osteochondral fragment (5)[C].
Commonly Associated Conditions
- Acetabular fractures
- Exclude closed head injuries, thoracic injuries, and abdominal and pelvic injuries in high-velocity injuries.
There's more to see -- the rest of this topic is available only to subscribers.