Traumatic Hip Dislocation/Subluxation

When the femur moves out of its normal position in the socket Two general categories of hip dislocations exist, anterior and posterior.

Tissues Involved: The iliofemoral ligament that attaches to the anterior inferior iliac spine of the pelvis and the intertrochanteric line of the femur. The pubofemoral ligament that originates at the superior ramus of the pubis, also attaching to the intertrochanteric line of the femur. The ischiofemoral ligament that connects the ischium to the greater trochanter of the femur. The transverse acetabular ligament that consists of the labrum covering the acetabular notch. The femoral head ligament that joins the femoral head with the transverse ligament and acetabular notch.

How is it caused? In general: Falling from high places Motorcycle/car accidents High energy impact In sports: an athlete landing in the splits with the hip flexed, abducted, and externally rotated. striking the ground while the hip is flexed, adducted, and internally rotated

Sport Examples: Getting hit in football/rugby Falling when skiing or snowboarding Running, jumping, or landing awkwardly in sports like basketball or gymnastics

There is no specific group. Age Groups Affected by it:

Symptoms Pain Probably wont be able to walk Leg length will be shortened

Treatment Surgery Two common techniques for performing a posterior hip reduction (the most common kind of hip dislocation) are the Allis Maneuver and the Stimson Maneuver. Both maneuvers require the use of physical force to push the hip back into place and are performed with the patient sedated. The hip and knee are flexed to a 90-degree angle when a surgeon applies the Allis Maneuver. The Stimson Maneuver has the dislocated leg hanging over the edge of the bed with the hip and knee also flexed at a 90-degree angle

More treatment… After the surgery, the patient will be placed on bed rest with the legs abducted and with a skeletal traction designed to keep the hip in place. The traction period will most likely last two weeks, but the patient may not be able to put weight on the injured leg for a longer period of time. Anti-inflammatory medications may be prescribed. Overall, the athlete should stay on crutches for at least six weeks, without putting any weight on the hip. If the follow-up MRI reveals no early manifestations of AVN (avascular necrosis), the player can slowly resume normal activities.

Preventions/precautions?

Interesting Information 70% of all hip dislocations are due to motor vehicle accidents Rarely occurs in sports Posterior dislocations comprise % of all hip dislocations and 90% of all sports-related hip dislocations