Traumatic Hip Dislocation
By Cameron Delicato, PTA
A traumatic hip dislocation occurs most frequently during an auto collision, high-impact fall, workplace, or sports activities. If someone suffers any forceful impact that corresponds with serious hip pain, which could be groin, leg, or even knee pain, they should visit an orthopedic specialist to determine whether there is traumatic hip dislocation.
There are two types of Hip dislocation:
- Simple: The hip joint ball is out of the socket without any fractures.
- Complex: The ball of the hip is pushed out of the socket. This can happen with a fracture of the acetabulum or proximal femur.
Anatomy of the Hip
The hip joint is includes the ball (femoral head) and the socket (acetabulum). The ball rotates in the socket, allowing the leg to move in all directions. During most traumatic hip dislocations, the femoral head is forced out of the acetabulum toward the rear, called a posterior dislocation. However, less often, the joint’s ball pushes forward from the pelvis, called an anterior dislocation.
The most serious incident regarding a traumatic hip dislocation is creating trauma to adjacent blood vessels, nerves, muscles, ligaments, and other tissue damage. This is a medical emergency and needs to be treated immediately, ideally within 5-7 hours. This is due to an injury that could stop blood from reaching the top of the femoral head, depriving the bone of its oxygen supply. Unless the hip is put back into its socket promptly and normal circulation is restored, the femur’s top can be permanently damaged, called avascular necrosis (bone death). Hip dislocation can also cause sciatic nerve damage, which can lead to limiting someone’s mobility.
To diagnosis a dislocated hip, an orthopedist will conduct an exam, usually in conjunction with ordering imaging of the hip, such as an X-ray, MRI, and/or a CT scan.
Depending on if it’s a simple or complex dislocation, an orthopedist can push the ball back in by hand while the patient is under anesthesia, called a manipulation. However, if the imaging reveals fractures or significant damage to surrounding structures, orthopedic surgery may be required.
Total Hip Replacement (THR)
Hip dislocation can occur after receiving a THR; however, they are relatively infrequent among otherwise healthy individuals who follow their surgeon’s precautions. However, there is a higher rate of dislocations in the elderly population, those with physical disabilities, and those who had prior hip dislocations before receiving a THR.
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