hip dislocation, causes &evaluation · 2013. 11. 25. · hip joint •ball-and-socket joint...
TRANSCRIPT
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Hip dislocation, Causes & Evaluation
M. N. Naderi , MD
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Hip joint
• ball-and-socket joint
• Inherently stable joint
• Strong capsuloligamentous coverage
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Hip dislocation
• high-energy trauma
• Post dx > ant dx
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Role of force & hip position in Dx
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Common Associated Fractures
• Pelvic ring fractures
• Femoral neck fractures
• Acetabular fractures
• Femoral head fractures
• Knee ligament injuries
• Spine injuries
• Femoral shaft fractures
Suspect these patient as multiple trauma patients
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Classification
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Signs & symptoms
• Pain
• Limb deformity
– Internal rotation in Post Dx
– External rotation in Ant dx
• Shortening of affected limb
Diagnosis of hip Dx may delayed due to more life-threatening associated injuries
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Evaluation
• History & Physical exam
– palpation of all long bones and joints of extremity
– meticulous N/V exam
– Examination of spine and pelvis
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• Imaging
–X-ray
• AP Pelvic x-ray
– CT Scan In true AP pelvic view the head will appear - larger than the contralateral if the dx is ant. - smaller the contralateral if dx is post.
Initial X-ray must be of good quality and inspected for associated injuries before reduction is attempted (In particular, associated femoral neck fractures )
Evaluation
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• Imaging – X-ray
• AP Pelvic x-ray
–CT Scan • Usually indicated after CR
• detecting intraarticular fragments, femoral head fx, acetabular fx & joint incongruity
Evaluation
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Pathoanatomy
• Femoral head injury
• Labral tear
• AVN
• DJD
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Summary
• Emergency situation
• Early reduction
• Beware of associated injuries
• N/V evaluation
Thank you for attention