Hip dislocation

Overview

A dislocated hip is a condition that can be congenital or acquired. Congenital hip dislocations are much more common in girls than in boys. Hip dislocations are relatively uncommon during athletic events.1 Injuries to small joints (eg, finger, wrist, ankle, knee) are much more common. However, serious morbidity can be associated with hip dislocations, making careful and expedient diagnosis and treatment important for the sports medicine physician.

Causes

* High-speed, high-impact sports are the most common setting for hip dislocations. o Unsafe and poorly maintained playing surfaces may add to the risk of participating in high-impact sports. For instance, wet surfaces provide an environment where athletes are more prone to lose control of their bodies while running and jumping. However, no evidence exists to link these factors with an increased incidence of hip dislocations. o One case report describes a basketball player who slipped on a wet court and dislocated his hip.5 * Although warming up before an activity and stretching on a regular basis may help prevent some sporting injuries, no evidence suggests that this decreases the risk of hip dislocation. * No correlation exists between athletic experience and hip dislocations.

Treatment

Physical Therapy Acutely after successful reduction, resting and icing the hip and taking anti-inflammatory and/or narcotic medications to reduce pain are helpful. * For type 1 posterior dislocations, athletes may return to weight bearing as pain allows. o Reviews of the literature do not show an increased risk of avascular necrosis with early weight bearing. o Athletes with type 2-5 posterior dislocations and anterior dislocations may require longer times to achieve weight bearing. * Hip joints with associated fractures and/or instability are placed in a hip abduction brace postoperatively, which keeps the hip in abduction and slight external rotation for optimal healing, while allowing controlled (limited) flexion and extension. Within 5-7 days of the injury, patients can perform passive range-of-motion exercises with or without assistance in order to maintain normal flexibility (pendulum exercises).