Skip to main content

Trauma of the Hip and Femoral Shaft

  • Chapter
  • First Online:
  • 728 Accesses

Abstract

Hip dislocations are usually high-energy injuries. Posterior dislocations are the most common and often associated with sciatic nerve injury. The classical clinical picture includes pain, shortening, and a flexion/adduction/internal rotation posture of the lower extremity. A plain AP pelvis x-ray should confirm the diagnosis and rule out associated bony injuries. Anesthesia or sedation, preferably with muscle relaxation, is necessary for reduction. Trolleys and OR tables are narrow and unstable, making it safer to place the patient on a mattress on the floor for reduction, while an assistant applies downward pressure on the anterior superior iliac spines. Traction in line with the axis of the femoral displacement—the Allis maneuver—will reduce the dislocation, usually with a clunk after which the leg is extended and externally rotated (https://www.youtube.com/watch?v=sGQZaqB48rw).

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Dwyer AJ, John B, Singh SA, Mam MK. Complications after posterior dislocation of the hip. Int Orthop. 2006;30(4):224–7.

    Article  CAS  Google Scholar 

  2. Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthopol. 2011;45(1):15–22.

    Article  Google Scholar 

  3. Jamal Sepah Y, Umer M, Khan A, Ullah Khan Niazi A. Functional outcome, mortality and in-hospital complications of operative treatment in elderly patients with hip fractures in the developing world. Int Orthop. 2010;34(3):431–5.

    Article  Google Scholar 

  4. Gupta A. The management of ununited fractures of the femoral neck using internal fixation and muscle pedicle periosteal grafting. J Bone Joint Surg Br. 2007;89(11):1482–7.

    Article  CAS  Google Scholar 

  5. Carsen S, Park SS, Simon DA, Feibel RJ. Treatment with the SIGN nail in closed diaphyseal femur fractures results in acceptable radiographic alignment. Clin Orthop Relat Res. 2015;473(7):2394–401. Free PMC Article.

    Article  Google Scholar 

  6. Young S, Lie SA, Hallan G, Zirkle LG, Engesaeter LB, Havelin LI. Low infection rates after intramedullary nail operations in 55 low- and middle-income countries: validation of the Surgical Implant Generation Network (SIGN) online surgical database. Acta Orthop. 2011;82(6):737–43.

    Article  Google Scholar 

  7. Young S, Lie SA, Hallan G, Zirkle LG, Engesæter LB, Havelin LI. Risk factors for infection after intramedullary nails operation in low- and middle-income countries. World J Surg. 2013;37(2):349–55.

    Article  Google Scholar 

  8. Pearson CA. Early protected weight bearing in African patients with fractures of the femur. Injury. 1977;9(2):89–92.

    Article  CAS  Google Scholar 

  9. Yokoyama K, Itoman M, Shindo M, Kai H, et al. Deep infection and fracture healing in immediate and delayed locked intramedullary nailing for open femoral fractures. Orthopedics. 1999;22(5):485–90.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Richard A. Gosselin .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gosselin, R.A., Quasem, F., Zirkle, L.G. (2020). Trauma of the Hip and Femoral Shaft. In: Gosselin, R., Spiegel, D., Foltz, M. (eds) Global Orthopedics. Springer, Cham. https://doi.org/10.1007/978-3-030-13290-3_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-13290-3_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-13289-7

  • Online ISBN: 978-3-030-13290-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics