This document discusses hip dislocations, including types, causes, signs, treatments, and complications. It describes three main types of hip dislocation - posterior, anterior, and central. Posterior dislocations are the most common and often result from dashboard injuries, causing the leg to appear short, adducted, internally rotated and flexed. Treatment involves closed or open reduction depending on the severity of the dislocation and any fractures. Complications can be early such as nerve palsies or late such as avascular necrosis and osteoarthritis.

1. DISLOCATION OF
HIP JOINT

2. DISLOCATION
• Joint surfaces are
completely displaced
• Clinical features
• Pain
• Restriction of movements
• Limb held in characteristic
position

3. • Signs
• Abnormal shape of joint
• Displaced bony landmarks
• Investigation
• X-RAY, CT
• Treatment
• Reduction
• Immobilization
• rehabilitation
• Complications

4. HIP JOINT DISLOCATION
According to direction of
femoral head displacement
• Posterior
• Anterior
• Central

6. BLOOD SUPPLY

8. POSTERIOR
DISLOCATION
• Dashboard injury
• Clinical features
• Short leg
• Adducted
• Internally rotated and slightly
flexed

10. • In every case of severe hip
injury X-RAY PELVIS.
• If femoral shaft #
X-RAY HIP AND KNEE

12. THOMPSON AND EPSTEIN
CLASSIFICATION
Types Description
i Dislocation with no more than
minor chip #
ii Dislocation with single large
fragment of posterior
acetabular wall
iii Dislocation with comminuted
fragments of posterior
acetabular wall.
iv Dislocation with # through
acetabular floor.
v # through acetabular floor and
femoral head

13. ANTERIOR DISLOCATION
• Mechanism
• Clinical features
• Externally rotated, abducted
and slightly flexed leg
• Anterior bulge of dislocated
head.

15. EPSTEIN’S CLASSIFICATION
Types Description
i Superior (pubic) dislocation
ia Simple (no assc #)
ib With # of head or neck of femur
ic Dislocation with # of acetabulum
ii Inferior dislocation (obturator )
iia Simple
iib # of head or neck of femur
iic # of the acetabulum

16. CENTRAL DISLOCATION
• Mechanism
• Clinical features
• No shortening , no ext rotation
deformity, no externally
palpable head.
• Neutral limb
• Severe pain and restriction of
movts

18. CLASSIFICATION (JUDET’S TYPE)
Undisplaced #
Inner wall #
Superior dome #
Bursting #

19. PHYSICAL EXAMINATION
• Inspection
• Attitude
• swelling
• Palpation
• greater trochanter
• Head of femur
• tenderness

20. MEASUREMENTS
• Bryant’s triangle
• Nelaton’s line
• Schoemaker’s line
• Morris’ bitrochanteric test
• Chiene’s test
• Length of lower limb

21. MOVEMENTS
• X-Ray
Treatment
• Posterior dislocation
• Allis method(reduction)
• Type I
• Closed
• Hip protection
• Post-reduction x-ray

24. • Type ii
• Open reduction
• Type iii, iv, v
• Indications for open
reduction
• Failed closed reduction
• Failed stability test
• Large acetabular fragment
• # of femur head
• Sciatic nerve palsy

25. ANTERIOR DISLOCATION
• Same as posterior except
that while flexed knee is
being pulled and hip gently
flexed upwards it should b
kept adducted.

26. CENTRAL DISLOCATION
• Skeletal traction
• Open reduction
• Primary arthroplasty

27. COMPLICATIONS OF HIP
DISLOCATION
• Early
• Sciatic nerve injury
• Vascular injury
• # femoral shaft
• Late
• Avascular necrosis
• Myositis ossificans
• osteoarthritis