2. Dislocation is the moving out of the touch surface of the joint.
This injury results from the force that causes the joint to exceed its
normal anatomical limits.
Articulatio coxae is a "ball and socket" joint formed from the
femoral head and the acetabulum. This articulation has many
palpable protrusions. The anterior superior iliac spine and the major
trochanter are easily palpable structures in the lateral region, and
the pubic symphysis and tuberculum (about 1 inch lateral of
symphysis) can be palpated from the medial side. Articulatio coxae
is a joint with a very broad movement.
DEFINITION
4. Articulatio coxae is a complex,
ball-and-socket joint that allows 3-
dimensional movement. But the
range of motion in this
articulation is still less compared
to humic articulation (which is
also a ball-and-socket joint)
because the acetabulum cavity is
deeper than the glenoid cavity
5. TRAUMA MECHANISM
• trauma such as mild falls and slipping
can result in dislocation of this
articulation due to overall weakness of
the joints and soft acetabulum cartilage
in this age group.
young age
group (<5
years)
• art.coxae dislocations are more often
due to high-energy trauma
(11-> 15
years),
6. Posterior
hip
dislocation
• occurs as a result
of trauma to the
distal femur
directed posteriorly.
Posterior hip
dislocation occurs
after a collision in
the knee where the
coxae is in a flexed
position.
Anterior
hip
dislocation
•resulting from direct trauma
from the anterior which occurs
in the femur in abduction and
external rotation position. The
femoral head moves anteriorly.
This dislocation occurs as a
result of trauma to the
adduction position which
causes a shift from the femoral
collum or trochanter to the
peak of the acetabulum arch
and lifts the femoral head
through the tear in the anterior
capsule.
DISLOCATION OF THE HIP IS DIVIDED INTO 3 TYPES OF
DISLOCATION, NAMELY:
10. anamnesis
•At the beginning of the trauma the patient will come with complaints of pain in the pelvis and shortening of
the inferior limb when compared to the contralateral side.
Physichal
examination
•Inspection (look)
•Palpation (feel)
•move
•NVD
Supporting
examination
•Radiology (X-Ray)
DIAGNOSIS
14. Anterior dislocations are more difficult to reduce than
posterior dislocations. If a reduction has been made up to 2
times with optimal and unsuccessful sedation, the patient
must be taken to the operating room. In the position of the
limbs, external rotation, abduction and flexion, traction is
carried out in one line position.
ANTERIOR HIP DISLOCATION
The Allis method
for reduction in
anterior pelvic
dislocation.
15. Central dislocation requires skeletal traction through the distal femur to
return the femoral head to its anatomical position. Because the central
dislocation is associated with an acetabulum fracture, which is usually
comminutive, the displacement of the femoral head to the medial must
be returned to its anatomical position
CENTRAL HIP DISLOCATION
16. An anterior approach is carried out
for anterior and direct dislocations
on the anterior (Smith-Peterson)
or from the anterolateral (Watson-
Jones). Literature for surgical
intervention in anterior
doslocation is rarely encountered
because most of it is concentrated
for closed reduction
OPEN REDUCTION :
I N D I C A T I O N : I F I T FA I L S T O P E R F O R M C L O S E D R E D U C T I O N A N D D I S LO C AT I O N A C C O M PA N I E D B Y
D I S P L AC E M E N T O F T H E H E A D O R C O L L U M F E M O R I S O R A C E TA B U LU M F R A C T U R E .
The standard posterior approach that is
often used is Southern or Moore, in
posterior dislocations
17. The patient is bed rested and is immobilized with skin traction for 2 weeks, then mobilizes
non-weight bearing for 3 months or bed rest until pelvic joint pain disappears, then
immediately mobilizes partial weight bearing.
POST REDUCTION CARE
Follow up
18. COMPLICATION
• ischiadic nerve injury that can occur around
10-20% in the case of dislocations but can
usually be avoided. This complication is
more common in cases of dislocation with
fractures than pure dislocation
Early
complication
• Avascular nekrosis
• Myositis ossificans
• Secondary osteorthritis
• recurent dislocation
Further
complications
19. The prognosis of dislocation depends on the development of AVN,
arthritis, and heterotopic ossification. It is reported that a good
prognosis is around 48% to 95%. The dislocation prognosis is
accompanied by a fracture based on the development of the
fracture that occurred.
PROGNOSIS
