Hip Dislocation

Aetiology

  • Typically due to impact during RTA or contact sports with the hip flexed

Pathophysiology

  • Most commonly posterior
    • Force is driven along the femur proximally, so femoral head typically dislocates posteriorly with an acetabular rim fracture
  • Associated fractures - posterior acetabular wall, femoral

Clinical presentation

  • Flexed, internally rotated and adducted knee

Investigations

  • Neurovascular assessment (particularly sciatic nerve)
  • X-ray
  • CT after reduction if further injury suspected

Management

Immediate

  • Urgent reduction
  • Stabilise in tractions if required

Definitive

  • Fixation of associated pelvic fractures
  • Fixation of other injuries in poly-trauma patients

Complications

  • Sciatic nerve palsy
  • AVN femoral head
  • Secondary OA of hip