The Basics of a Traumatic Hip Dislocation

Hip dislocations that are a result of trauma usually happen with a high-energy injury. This article will not discuss this dislocation of artificial hip replacement, rather the dislocation of a hip from trauma. When a person is in a car accident or has a fall from a height, the hip can dislocate if the force is high enough. Over 90% of the time, it is dislocated backwards which is called posterior. If a hip dislocation is not addressed in a timely fashion, the patient is at risk of having the bone around the hip joint die and possibly sustain a sciatic nerve injury.

Along with a hip dislocation, patients often have significant associated injuries because the force was so high. This can result in a fracture of the socket where the hip normally sits. This is called the acetabulum bone. The pelvis may have a fracture or the head of the femur itself may sustain a break.

When the bone dies around the hip, this is called osteonecrosis and is where the head of the femur actually loses its blood supply. This is what happened to Bo Jackson during his football injury where he sustained a hip dislocation and subsequent loss of the blood supply to the hip. He ended up needing a hip replacement. This can happen in up to 40% of hip dislocations if they are not relocated properly and in a timely fashion.

Once a patient has a hip put successfully back in the place, weight-bearing is usually limited for the next 4 to 6 weeks. Putting the hip back into position is not always an easy task. The patient should have muscle sedation and significant amount of pain medication. The maneuver involves traction delicately on the hip and some hip flexion and some gentle external rotation. At times there will be some bone in the way or maybe some soft tissue, which may make it impossible to successfully put it back in the place. If that is the case, surgery will be necessary emergently to facilitate this reduction.

After the hip is successfully put back into place, a physical examination should be done to check for a stable range of motion along with getting new x-rays. The CAT scan may be necessary as well to see if there is a fracture. Under 10% of hip dislocations come out the front and this is called an anterior hip dislocation. There's a high risk of vascular injury with these dislocations and they also should be treated as an emergency.