39. Traumatic dislocations of the hip joint

Essay 39- Traumatic sprains of the hip joint

• General information
• 3rd most common dislocation after the shoulder and elbow
• Reasons why it is rarely seen:
• Strong ligament and joint capsule surrounded by powerful muscles
• Deep acetabular cavity
• Less range of motion than the shoulder joint
• Etiology (mechanisms)
• Indirect lever damage causes dislocation of the head of the femur
• Dislocation and be anterior or posterior
• Dislocations can be pure or with a fracture
• Fracture dislocations are common in car accidents when the knee is flexed and the leg strikes the dashboard
• Injury is characterised as high energetic
• Symptoms
• Motionless patient as any change in the position causes pain
• Joint deformity superior displacement of the trochanter in posterior luxations
• Forced position of the leg is typical for the type of dislocation
• Distinct edema
• Intensive pain
• Shortening of the limb
• Absence of function
• Diagnosis
• X-ray confirms the diagnosis
• Treatment
• Reduction of the joint if possible in the first few hours
• Done under general ansesthesia!
• Boychev reduction
• Supine position, legs spread apart, foot against the perineum
• Pull thigh with both arms using rotary movements
• The femoral head finds the acetabulum with a click

• Janelidze reduction
• Patient in prone position
• Affected limb is bent at 90 degrees and another arm holds shank
• Rotary movements done until a click is heard!