Dislocation Reduction of the Hip Joint (Orthopaedics)

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  • Native hip dislocations: posterior or anterior
  • Prosthetic hip dislocations
  • There are no absolute contraindications to closed reduction of hip dislocations.
  • Lifesaving procedures must be performed first.
  • Associated fractures may require surgical reduction.

No specific equipment is required for closed reduction of the hip.

  • The diagnosis is based on the position of the femoral head and the acetabulum.
  • The medial and lateral circumflex femoral arteries supply the femoral head.
  • The sciatic nerve is posterior to the hip and can be injured in posterior dislocations.
  • The femoral artery and nerve can be damaged in anterior dislocations.
  • Posterior hip dislocations are by far the most common.
  • The femoral head comes to lie posterior to the acetabulum and assumes a semi-flexed, internally rotated position.
  • In anterior hip dislocations, the femoral head is displaced anterior to the acetabulum.
  • The femoral head may be seen lying over the obturator foramen.

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  • Reexamine the hip range of motion to assess stability.
  • Repeat the neurovascular examination.
  • Immobilization
  • For posterior dislocations, use a simple knee immobilizer.
  • For anterior dislocations, an abduction pillow may be helpful.
  • If the hip remains unstable, a traction pin should be placed.
  • Obtain imaging studies immediately after reduction.
  • Arrange for definitive care and rehabilitation.
  • Precautions after posterior dislocation: avoid flexion of the hips past 45 degrees with internal rotation.
  • Precautions after anterior dislocation: avoid hyperextension of the hip with external rotation.
  • Avascular necrosis (AVN) of the femoral head
  • Osteoarthritis
  • Nerve injury
  • Vascular injury
  • Heterotopic ossification (HO)
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