Definition:- 1) Hip dislocation occurs when the head of the femur is forced out of its socket in the hip bone (pelvis). It typically takes a major force to dislocate the hip. 2) A hip dislocation a disruption of the joint between the femur and pelvis. 3) A hip dislocation occurs when the ball-shaped head of the femur (thigh bone) moves out of its socket on the pelvis. In most cases, this requires a traumatic force to the thigh bone.

1. DR. NIRAJ KUMAR
MPT ORTHO
HIOD/ASSOCIATE PROFESSOR
SGRRIMHS,PATEL NAGAR

5. Definition:-
1) Hip dislocation occurs when the head of the femur
is forced out of its socket in the hip bone
(pelvis). It typically takes a major force to
dislocate the hip.
2) A hip dislocation a disruption of the joint
between the femur and pelvis.
3) A hip dislocation occurs when the ball shaped
head of the femur (thigh bone) moves out of its
socket on the pelvis. In most cases, this requires a
traumatic force to the thigh bone.

6. Very severe violence to causes a dislocation of
a normal hip joint:-
1. 1.Fall from height
2. 2.Industrial injury
3. 3. RTA

8. 1.Posterior dislocation
2.Anterior dislocation
3.Central dislocation

9. Posterior dislocation:-
DEFINITION:-
Posterior dislocation is the commonest type of
dislocation. It is due to violence applied along the
femoral shaft when hip is in flexed, adducted &
internal rotatated position.
It is seen automobile accident –When the
passenger sitting by the driver is thrown forward,
his knee hitting against the dashboard
Posterior dislocations comprise approximately 80-
90% of hip dislocations caused by MVCs. The femoral
head is situated posterior to the acetabulum.

12. 1. Severe pain , Swelling &Tenderness
2. Inability to sand or walk
3. The position of limb is in adduction
+flexion + Internal rotation
4. Shortening
5. GT is raised & head of femur felt posterior
under Gluteal muscles
6. paralysis- sciatic nerve injury- foot drop

16. Dislocation is reduced by manipulation under GA
•After reduction the limb can be placed in normal
position and a firm elastocrepe spica bandage is
applied to the hip & leg is immobilized in a Thomas
splint for 3 to 4 weeks
•NSAID along with MR is the choice of Tx for pain and
for reduce the tension of muscle
•Full weight bearing allowed after six week

17. 1] Flex the hip and knee to 90º and apply steady
forward traction. The head slips forward into position.
2] Bigelow technique:-
Patient in supine position on a mattress surgeon stand
& gripping the pt. leg by knee & ankle bending . While
assistant fixed the pelvis with both hand than surgeon
leg circumducted through external rotation , abduction,
and extension results the head felt to reduced with
audible sound.

18. 1] Femoral head situated anterior to acetabulum
2] In an anterior dislocation the limb is held by the
patient in externally rotated with mild flexion and
abduction. Femoral nerve palsies can be present, but
are uncommon.
3] Hyperextension force against an abducted leg that
levers head out of acetabulum.
Also force against posterior femoral head or neck can
produce anterior dislocation 10 % to 15% of traumatic
hip dislocation.

19. • Extreme abduction with external rotation of hip.
• Anterior hip capsule is torn or avulsed.
• Femoral head is levered out anteriorly.
Types of anterior dislocation
1] Obturator type:- In this type HOF slips forward &
lies over the obturater foramen.
2] Pubic type:- In this type HOF slips forward & lies
near the pubis symphysis.
• Perineal type:- In this type HOF felt anteriorly in
medial aspect of groin.

20. A central dislocation a rare type of dislocation and it is
always a fracture-dislocation. This is caused by a violent
lateral aspect of the hip and lateral force against an
adducted femur as commonly seen in side impact MVCs.
Floor of acetabulum get multiple fracture HOF is pushed
into the pelvis.
C/F:- Severe pain in the hip, fl & Ext movt. relatively free
but limitation of abduction & rotation. And some time
hemispherical bulge of lateral wall of rectum.
Treatment:- Continuous heavy skeletal traction is applied
to limb with 30 degree abduction for 4 to 6 weeks.
Sometime surgical fixation of articular surface is done.

21. DURING IMMOBILISATION
Acutely after successful reduction,
1. Rest and icing the hip and taking anti-inflammatory
and/or narcotic medications to reduce pain are helpful.
2. Non-Weight bearing with the help of crutches should
begin immediately after the patient is pain free and
transitioned to full weight bearing as pain allows.
3. Strong Isometrics to Glutei, Hip Flexor, Quads &
Hams
4. In skeletal traction small ROM can be initiated by 3
wks.
5. Avoid- Hip adduction & IR with Flexion in post. Dislo
Hip abduction & ER in ant. Disl.

22. DURING MOBILISATION
1. Full range of motion of the hip joint.
2. Mobilization of knee.
3. Hip & Leg muscle strengthening exercises may begin as
hip flexors, hip extensors, and the muscles nearest the
hip, including the quadriceps and hamstrings.
4. Ambulating without crutches. (FWB).
5. Assisted SLR should be initiated.
6. Controlled hip movement after 12 wks.
7. Independent Ambulation after 15-16 wks.
8. Cardiovascular training may be attempted, which
should include brisk walking and swimming. Jogging or
running may begin at 6-8 weeks but will differ by
individual athlete and injury. Full return to sports is
generally within 3-4 months.

23. Nerve injury. Injury to the sciatic nerve may cause
weakness in the lower leg and affect the ability to
move the knee, ankle and foot normally.
Osteonecrosis. It can tear blood vessels and blood
supply to the bone is lost, the bone can die, resulting
in osteonecrosis (also called avascular necrosis).
Arthritis. The protective cartilage covering the bone
may also be damaged, which increases the risk of
developing arthritis in the joint.