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Traumatic Hip Dislocations

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Fractures of the Hip

Part of the book series: Fracture Management Joint by Joint ((FMJJ))

Abstract

Pure hip dislocations are relatively unusual, but represent an injury with significant capacity for resulting in long-term disability. The femoral head most commonly dislocates posteriorly (80–90%), typically caused by axial force on the femur with the hip flexed as seen in dash board injuries. Concomitant pathomorphologies of the hip such as cam-type impingement, or femoral retrotorsion are a risk factor for posterior dislocation. Anterior dislocations are not that unusual, forming approximately 10% of most series. Other forms of pure dislocation are very unusual, i.e. obturator and central dislocation and are mostly a fracture dislocation. Early reduction is essential to improve outcome, and certainly within 12 h of injury, although as early as is safely possible is ideal. CT scanning is the current standard imaging; examination under anesthesia to assess stability aids planning and early post-operative mobility is probably beneficial. Surgery is reserved for irreducible dislocations, associated fractures, incongruence after reduction, or significant instability found at examination under anesthesia (EUA). Long-term hip outcomes are mostly excellent or good, but avascular necrosis (AVN) and post-injury arthritis affect up to 20% of cases. Associated injuries are common in this group, and often determine the overall patient outcome.

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Author information

Authors and Affiliations

  1. Centre for Orthopaedic and Trauma Research, Discipline of Orthopaedics and Trauma, University of Adelaide, Adelaide, SA, Australia

    Mark Rickman

  2. Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia

    Mark Rickman

  3. Department of Orthopaedic Surgery, Kantonsspital Aarau, Aarau, Switzerland

    Lorenz Büchler

Authors
  1. Mark Rickman
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  2. Lorenz Büchler
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Correspondence to Mark Rickman .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Kantonsspital Aarau, Aarau, Switzerland

    Lorenz Büchler

  2. Trauma Center Hirslanden, Clinic Hirslanden, Zürich, Switzerland

    Marius J.B. Keel

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Rickman, M., Büchler, L. (2019). Traumatic Hip Dislocations. In: Büchler, L., Keel, M. (eds) Fractures of the Hip. Fracture Management Joint by Joint. Springer, Cham. https://doi.org/10.1007/978-3-030-18838-2_9

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  • DOI: https://doi.org/10.1007/978-3-030-18838-2_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18837-5

  • Online ISBN: 978-3-030-18838-2

  • eBook Packages: MedicineMedicine (R0)

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