MANAGEMENT OF HIP DISLOCATION IN EMERGENCY DEPARTMENT
SAAD SALEH ALGHUNAYMI
Senior Registrar Orthopedics, Prince Metaab Bin Abdulaziz Hospital, Saudi Arabia.
MOHAMMED HAMOUD ALKHALDI
Jouf University, Aljouf, Saudi Arabia.
ALKHALDI, MOHAMMED AMID S.
Prince Metaab Bin Abduel Aziz Hospital, Sakaka, Saudi Arabia.
ALMARI, MUSAAD MOHAMMED N.
Prince Metaab Bin Abduel Aziz Hospital, Sakaka, Saudi Arabia.
ALRUWAILI, RAYAN KHALAF I.
Jouf University, Aljouf, Saudi Arabia.
ALHASSAN, OMAR ABDULAZIZ A.
Dumat Aljindal General Hospital, Aljouf, Saudi Arabia.
ALENZI, OSAMA MOHAMMED F.
Jouf University, Aljouf, Saudi Arabia.
ALMOALLEM, SALEH ABDULLAH S.
King Khaled Hospital, Tabuk, Saudi Arabia.
ALZAHRANI, ABDULLAH MOHAMMED A.
King Abdullaziz Specialist Hospital, Taif, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Hip dislocations following trauma are a common occurrence in the emergency room. Since the hip is a ball and socket joint with concomitant muscular and ligamentous attachments, it often takes a large amount of force to dislocate a hip. Due to the needed force, hip dislocations frequently come together with additional serious injuries. 90% of the time, hip trauma appears as a posterior dislocation when detected because the anterior ligaments are stronger. The rectus femoris, gluteal muscles, and short external rotators make up dynamic muscular support. 95% of patients who had a hip dislocation following a car accident also had an accompanying injury that needed hospital treatment. Therefore, a thorough neurologic and musculoskeletal evaluation with further x-rays or CT scans for assessment is required in cases with native hip dislocation. Standard AP (anteroposterior) scans of the pelvis often show hip dislocations clearly. However, a cross-table lateral of the injured joint is often included in comprehensive imaging. Hip dislocations can be more difficult to reduce than other types of dislocations, and most patients need procedural anaesthesia to make the reduction easier. Before considering surgical reduction, experts advise making up to three closed reduction efforts. However, 10% of hip dislocations may not be treatable in the emergency room and require surgical reduction under general anaesthesia.
Keywords: Hip dislocation, musculoskeletal, ligaments, trauma