Introduction

Hip dislocation is an extremely painful condition that is mostly caused by direct trauma, particularly road traffic accidents and significant falls from height. Given the large forces required to cause most traumatic hip dislocation, it may be associated with other fractures and life-threatening injuries. Prompt diagnosis and appropriate management of hip dislocation are important to reduce morbidity.

Classification

Types of hip dislocation
  • Posterior dislocation: Accounts for 90% of hip dislocations. The affected leg is shortened, adducted, and internally rotated.
  • Anterior dislocation: The affected leg is usually abducted and externally rotated. No leg shortening.
  • Central dislocation

Clinical features

Investigations

Diagnosis is usually confirmed on pelvic X-ray.

Management

Management of hip dislocation
  • ABCDE approach.
  • Analgesia
  • A reduction under general anaesthetic within 4 hours to reduce the risk of avascular necrosis.
  • Long-term management: Physiotherapy to strengthen the surrounding muscles.

Complications

  • Sciatic or femoral nerve injury
  • Avascular necrosis
  • Osteoarthritis: more common in older patients.
  • Recurrent dislocation: due to damage of supporting ligaments

Prognosis

Prognosis
  • It takes about 2 to 3 months for the hip to heal after a traumatic dislocation
  • The prognosis is best when the hip is reduced less than 12 hours post-injury and when there is less damage to the joint.