Hip Dislocation

Dislocation is an injury to a joint, in which two adjoining bones shift out of alignment and are no longer touching. Dislocation of the hip joint (between the thigh bone and the pelvic bones) is a serious injury. It is common for a fracture to also occur when the hip is dislocated. Other injuries may include damage to soft tissues (cartilage, tendons, or ligaments), bone damage, damage to blood vessels, or nerve injury.

SYMPTOMS

  • Severe pain at the time of injury.

  • Pain when moving the hip.

  • Loss of hip function.

  • Inability to stand on affected leg.

  • Visible deformity, if the bones have locked in the dislocated position.

  • Tenderness, swelling, and bruising of the hip.

  • Numbness or paralysis below the dislocation, from pinching, cutting, or pressure on the blood vessels or nerves.

CAUSES

Hip dislocations are usually the result of a direct hit (trauma) to the hip or knee. Some people may be predisposed to hip dislocations because of a birth defect (congenital abnormality), such as shallow or malformed joint surfaces.

RISK INCREASES WITH:

  • Contact sports (i.e. football, hockey).

  • Previous hip injury.

  • Poor hip strength and flexibility.

PREVENTION

  • Warm up and stretch properly before activity.

  • Maintain physical fitness:

  • Hip strength.

  • Flexibility and endurance.

  • Cardiovascular fitness.

  • After healing, protect hip with special hip pads.

  • Consider avoiding contact sports, if treatment is not successful in restoring a strong, stable hip.

PROGNOSIS

If treated properly, healing can be expected to occur within 3 months.

RELATED COMPLICATIONS

  • Related fracture or soft tissue injury.

  • Damage to nerves.

  • Damage to blood vessels, which may lead to an interrupted blood supply. This can cause death of the bone in the ball of the hip. It may not be apparent for up to 2 years following the injury.

  • Prolonged healing or recurring dislocation, if activity is resumed too soon.

  • Excessive bleeding within the hip.

  • Repeated hip dislocations (rare).

  • Unstable or arthritic joint, after repeated injury.

TREATMENT

Hip dislocations require immediate realigning of the bones (reduction). Realignment should be performed by a medically trained person. For some cases, surgery is required to realign the hip joint or to remove loose fragments (bone or cartilage). If the dislocation caused a fracture of the hip socket (acetabulum), surgery may be required to place pins and screws, to hold the bones together. After realignment or surgery, a patient must be partial or non-weight bearing on the affected hip for up to 6 weeks. This may include the use of crutches. A cast may be recommended to restrain the joint. However, this is uncommon. After the joint has been rested and allowed to heal, stretching and strengthening exercises for the injured and weakened joint and muscles are needed. Exercises may be performed at home or with a therapist.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised.

  • Do not take pain medicine for 7 days before surgery.

  • Prescription pain relievers are usually prescribed only after surgery. Use only as directed and only as much as you need.

HEAT AND COLD

  • Cold treatment (icing) should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used before performing stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm water soak.

SEEK MEDICAL CARE IF:

  • Pain, tenderness, or swelling gets worse, despite treatment.

  • You experience pain, numbness, or coldness in the foot.

  • Blue, gray, or dark color appears in the toenails.

  • Any of the following occur after surgery:

  • Signs of infection: fever, increased pain, swelling, redness, drainage of fluids, or bleeding in the affected area.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)