Symptoms, Causes, Diagnosis, and Treatment Methods for Hip Dislocation

Hip dislocation is a condition where the head of the femur is pushed forward or backward out of the joint where the hip joint and the upper leg connect. During this event, the muscles and connective tissues that function to keep the bones in place in the joint are also damaged. Nerve damage may also occur in some patients. This condition usually occurs as a result of events such as falls, injuries, or traffic accidents severe enough to cause bone fractures. A patient experiencing a dislocation may have difficulty using their upper leg. They may have difficulty walking or changing the position of their body. For treatment, surgical or non-surgical methods are used to ensure the bone is seated back into its socket.

What is Hip Dislocation?

Hip bone dislocation is the term used for the separation of the ball-like head of the thigh bone from the hip bone during events such as traffic accidents or falls from a height. It can also be called hip dislocation. It can cause intense pain and suffering, and it may not be possible to move the leg when a dislocation occurs. Additionally, if nerve damage occurs, loss of sensation may be observed. The resulting dislocation is a condition that requires emergency intervention, and delaying the intervention can result in permanent damage. It is a problem encountered more frequently in individuals with artificial hip prostheses. Hip dysplasia, where the hip bone does not settle correctly during the development process, can also create a risk of dislocation. Looking from the outside, the leg being locked in an outward or inward position can also help in understanding the problem.

How Does Hip Dislocation Occur?

Dislocation occurs when the thigh bone separates from the socket located on the hip bone after a hard impact or injury. Usually, in this case, the knee and foot become turned inward. It is almost impossible for the person to move their leg from its current position. After a unilateral hip dislocation, differences in length between the two legs are observed. In addition, color changes and bruising may be seen in the hip area. In children around 1 year of age, the waddling and limping gait known as the hip dislocation gait may be occurring due to the dislocation.

The dislocation problem can occur in situations such as serious accidents or sudden movements by athletes. Some of the reasons that can be counted include:

Vehicle accidents,

Falling from a high point,

Minor impacts in people with hip dysplasia,

Receiving a hard blow to the leg,

Incorrect intervention during birth.

All situations that result in the application of severe force on the leg and hip bones can be counted among the causes that can lead to dislocation.

How is Hip Dislocation Diagnosed?

In some cases, the patient's appearance and complaints may be sufficient for the diagnosis of the disease. The doctor needs to be thoroughly familiar with the answers to the questions of what hip dislocation is and what its symptoms are in order to make a diagnosis. The problem can be easily diagnosed if symptoms such as bruising on the hip, stiffness in the leg, the dislocation being directly visible from the outside, or loss of sensation are observed. During diagnosis, imaging methods such as X-ray, CT (computed tomography), and MRI (magnetic resonance imaging) can be used to reach a definitive decision. While problems such as fractures and cracks in the bones can be viewed with imaging methods, the position of the bones can also be examined in detail. When the ultrasound taken to view the bones is examined, it can be easily seen that the femoral head has separated from within the hip bone.

What Are the Treatment Methods for Hip Dislocation?

Dislocation occurring in the hip bone is a complaint that requires emergency intervention. When a situation is suspected of this problem, the patient should be prevented from moving their leg. By taking the necessary precautions, it is ensured that the patient is transported to the nearest health institution by ambulance or private vehicle. Having the intervention performed within a few hours after the event is important for success in recovery. Some of the treatment methods can be listed as follows:

Hip reduction: The reduction procedure, which is preferred as a non-surgical hip dislocation treatment, must be performed by a specialist doctor in the field. When secondary problems such as nerve damage or bone fractures do not occur, the bone is returned to its socket by applying an anesthetic to the patient. A significant amount of force may be required for this procedure.

Hip dislocation surgery: If damage to blood vessels and nerves occurs in the patient due to the dislocation, intervention in a surgical environment is required. During the surgery, after the bones are returned to their original place, the bones are stabilized to prevent the problem from recurring.

Hip dislocation splints: After treatment, some precautions are taken to minimize the risk of recurrence. In babies with congenital hip dislocation, the position of the bones is stabilized with special fabric splints for a 6-month period after treatment. This procedure has the feature of increasing the effect of the treatment.

Post-treatment procedures: Bed rest is not recommended after the application of dislocation treatment or after surgical procedures. Bed rest can lead to clot formation in the patient. During discharge, the use of crutches is usually recommended to the patient, and the patient can start walking normally after a one-week period. In addition to these, hip dislocation exercises are performed under the guidance of a physiotherapist, and the hip joint is ensured to be moved.

When is Hip Dislocation Surgery Necessary?

In cases where the dislocation does not cause secondary damage, applying force to return the bone to its place is sufficient. Situations where surgery is needed can be listed as follows:

The presence of bone fractures in addition to the dislocation,

The bone not being stabilized despite being returned to its place,

Damage to blood vessels and nerves in addition to problems in the bones.

After the hip dislocation symptoms are examined in detail in the patient coming with a suspicion of dislocation, information about the damage experienced can be obtained. In addition, the presence of fractures and cracks is evaluated with imaging methods. After the examinations, the doctor may decide to perform surgery.

Frequently Asked Questions

When symptoms of hip dislocation appear in adults, the patient should be directed to the emergency department of the nearest health institution without wasting time. During the doctor's examination, the patient's complaints are listened to, and visible problems are examined during the physical examination. After this process, a definitive diagnosis is decided with imaging methods. In treatment, work is done to return the bones to their original form. For hip bone dislocation that does not contain additional problems, the bone is placed back into the socket by applying pressure. Surgical intervention is needed for patients experiencing traumatic hip dislocation that also includes problems such as vascular and nerve damage. After treatment, the necessary precautions and changes must also be made so that the bones can regain their former functions. Dislocations in the hip can be seen in all people who have experienced severe accidents and received major blows. However, it is encountered more frequently in some people. It can emerge congenitally in patients with hip dysplasia due to problems experienced in the hip bone during the development process of the fetus in the mother's womb. This situation can be expressed as having a dislocation in the hip bone developmentally. In people with artificial hip prostheses for various reasons, the prosthesis can come out of the socket more easily compared to normal bones. It can also be experienced in people interested in heavy sports and dancing due to the body being forced more than necessary. If it is not treated within a few hours after the event occurs for recovery, permanent damage may occur. The bone separated from the hip bone creates pressure on the nerve extending from the back to the legs. The damage experienced due to this pressure can result in loss of sensation in the foot and leg. Problems in the blood supply of tissues can be experienced as the bone damages the vessel carrying blood to the legs. Cell death can occur in tissues that are not supplied with blood, and this can result in osteonecrosis. Abnormal movement of the bones can damage the cartilage tissue that keeps the bone in the socket. This can lead to hip dislocation calcification. In later ages, the need for a hip prosthesis may arise. In the post-operative process, physiotherapist applications are recommended so that the bones can return to their former activities. The physiotherapist has the patient lie on their back and performs some exercises for the hip joint to regain movement. The bones are ensured to work with methods such as the Allis maneuver, Bigelow maneuver, and Captain Morgan technique. In babies, especially after the developmentally occurring dislocation is treated, the use of splints is recommended to prevent the problem from recurring. Recovery can be seen in these patients after a 6-month period. In cases such as a re-accident after treatment, the patient receiving a heavy blow, or forcing their body more than necessary, the dislocation problem can be experienced again. It can be experienced frequently, especially in people with a high risk of hip dislocation. For this reason, it is recommended to be careful in the process after treatment. Especially people with hip prostheses and patients with developmental hip dysplasia should pay attention to their doctor's recommendations. In some patients, some precautions can be taken during surgery to prevent the dislocation from recurring. Whether the dislocation occurred during the development process in babies should be detected and intervened as soon as possible. Hip dislocation ultrasound can be performed 72 hours after the baby's birth. In addition, it can be examined in the newborn examination applied to 6-8 week old babies. In babies with a family history of this problem or who are born breech, a check is made in the examination applied to 4-6 week old babies. After deciding on surgery, the patient is sedated with an anesthesia method. For the surgical procedure, an incision is made in the necessary area, and the surgical area is opened. During the surgery, the protection of blood vessels is ensured. If there are bone fractures in the patient, these bones are stabilized with the help of screws. If there is damage to nerves and vessels, these areas are also intervened. Then, the surgical area is stitched and closed, and the procedure is completed. After this stage, painkillers can be used to reduce the patient's pain and suffering.

Hip dislocation is a serious health problem that requires emergency intervention. If you or your relatives have similar symptoms, apply to our specialist Orthopedics and Traumatology physicians without wasting time. Make an Appointment Now