Traumatic Hip Dislocation: Lecture

Abstract

Traumatic hip dislocations occupy the fourth place among dislocations of various localizations and, as a rule, are the result of  exposure  to  a  high-energy  traumatic  agent.  Such  injuries  are  more  often  observed  in  young  and  middle-aged  males. The main cause of hip dislocations is road accidents. The femoral head is more often dislocated posteriorly, but anterior dislocations  are  not  casuistic  and  account  for  approximately  10%.  Hip  dislocations  are  often  combined  with  acetabular fractures,  while  their  fairly  clear  clinical  picture  in  the  presence  of  fractures  can  be  leveled.  Traumatic  hip  dislocations require urgent diagnosis and treatment. After the clinical examination of the patient, an x-ray of the pelvis and hip joints are performed. Radiographic diagnosis of hip dislocation remains relevant, but modern imaging methods allows to study the hip joint in more detail and identify concomitant injuries. The main treatment for hip dislocation is closed reduction. Early dislocation reduction and the absence of damage to the structures forming the hip joint are important for the treatment results prognosis. The further patient management tactics after the dislocation reduction is determined by the results of stress tests and the CT data. When confirming the instability and associated injuries of the hip joint anatomical structures, surgical treatment is indicated. Among the complications of hip dislocation: sciatic nerve damage, post-traumatic coxarthrosis, the femoral head avascular necrosis, heterotopic ossification. Current literature data indicates the importance of early diagnosis of dislocation-associated injuries of the hip joint and periarticular tissues. Early and comprehensive repair of all existing injuries is crucial for favorable outcomes. A number of therapeutic and diagnostic methods, primarily arthroscopy, show optimistic results, but need further study.