Abstract
Pure hip dislocations are relatively unusual, but represent an injury with significant capacity for resulting in long-term disability. The femoral head most commonly dislocates posteriorly (80–90%), typically caused by axial force on the femur with the hip flexed as seen in dash board injuries. Concomitant pathomorphologies of the hip such as cam-type impingement, or femoral retrotorsion are a risk factor for posterior dislocation. Anterior dislocations are not that unusual, forming approximately 10% of most series. Other forms of pure dislocation are very unusual, i.e. obturator and central dislocation and are mostly a fracture dislocation. Early reduction is essential to improve outcome, and certainly within 12 h of injury, although as early as is safely possible is ideal. CT scanning is the current standard imaging; examination under anesthesia to assess stability aids planning and early post-operative mobility is probably beneficial. Surgery is reserved for irreducible dislocations, associated fractures, incongruence after reduction, or significant instability found at examination under anesthesia (EUA). Long-term hip outcomes are mostly excellent or good, but avascular necrosis (AVN) and post-injury arthritis affect up to 20% of cases. Associated injuries are common in this group, and often determine the overall patient outcome.
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Rickman, M., Büchler, L. (2019). Traumatic Hip Dislocations. In: Büchler, L., Keel, M. (eds) Fractures of the Hip. Fracture Management Joint by Joint. Springer, Cham. https://doi.org/10.1007/978-3-030-18838-2_9
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