Traumatic Hip Dislocation
By Cameron Delicato, PTA
A traumatic hip dislocation occurs most frequently during an auto collision, high-impact fall, workplace, or during sport activities. If someone suffers any forceful impact that corresponds with serious hip pain; could be groin, leg or even knee pain, then they should get examined by an orthopedic specialist to determine whether there is a traumatic hip dislocation.
Hip dislocation can be divided into 2 categories: Simple and Complex.
- Simple: When the ball of the hip joint is pushed out of the socket without any associated fractures.
- Complex: When the ball of the hip is pushed out of the socket however is also associated with a fracture of the acetabulum or proximal femur.
Anatomy of the Hip
The hip joint is compromised of 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 ball of the joint is pushed 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 considered a medical emergency and needs to be treated immediately, ideally within 5-7 hours. This is due to in injury could stop blood from reaching the top of the femoral head, depriving the bone of its oxygen supply. Unless the hip is replaced into its socket promptly and normal circulation is restored, the top of the femur can be permanently damaged called avascular necrosis (bone death). A 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 X-ray, MRI, and/or a CT-scan.
Depending if it’s a simple or complex dislocation, an orthopedist can simply push the ball back in by hand while the patient is under anesthesia called manipulation. However, if the imaging reveals fractures or significant damage to surrounding structures then an orthopedic surgery may be required.
Total Hip Replacement (THR)
Hip dislocation can occur after receiving a THR, however they are relatively infrequent among otherwise heathy individuals who follow precautions provided by their surgeon. However, there is a higher rate of dislocations that occur in the elderly population, those with physical disabilities, and those who had prior hip dislocations before receiving a THR.
JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.