MANAGEMENT OF HIP DISLOCATION IN EMERGENCY DEPARTMENT

Abstract

Hip dislocations following trauma are a common occurrence in the emergency room. Since the hip is a ball and socket joint with concomitant muscular and ligamentous attachments, it often takes a large amount of force to dislocate a hip. Due to the needed force, hip dislocations frequently come together with additional serious injuries. 90% of the time, hip trauma appears as a posterior dislocation when detected because the anterior ligaments are stronger. The rectus femoris, gluteal muscles, and short external rotators make up dynamic muscular support. 95% of patients who had a hip dislocation following a car accident also had an accompanying injury that needed hospital treatment. Therefore, a thorough neurologic and musculoskeletal evaluation with further x-rays or CT scans for assessment is required in cases with native hip dislocation. Standard AP (anteroposterior) scans of the pelvis often show hip dislocations clearly. However, a cross-table lateral of the injured joint is often included in comprehensive imaging. Hip dislocations can be more difficult to reduce than other types of dislocations, and most patients need procedural anaesthesia to make the reduction easier. Before considering surgical reduction, experts advise making up to three closed reduction efforts. However, 10% of hip dislocations may not be treatable in the emergency room and require surgical reduction under general anaesthesia.