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Posterior Hip Dislocation

Definition:
  • Posterior hip dislocation: Displacement of the femoral head out of the acetabulum towards the posterior aspect of the pelvis.
Epidemiology:
  • Represents approximately 90% of all hip dislocations.
  • Often results from high-energy trauma such as road traffic accidents.
Clinical Presentation:
  • Severe pain in the affected hip and inability to move the leg.
  • Limb appears shortened, adducted, and internally rotated.
  • Possible associated injuries, especially if trauma was the cause.
Investigations:
  • X-ray of the pelvis: Anteroposterior (AP) and lateral views are standard for diagnosis.
  • CT scan: To assess associated fractures or to guide treatment.
Management:
  • Immediate closed reduction: Under sedation or general anaesthesia to reduce risk of avascular necrosis of the femoral head.
  • Operative intervention if closed reduction fails or in the presence of associated fractures.
  • Post-reduction X-ray to confirm the correct positioning of the femoral head within the acetabulum.
  • Physiotherapy and mobilisation as soon as it is deemed safe.
Complications:
  • Avascular necrosis of the femoral head: Due to disruption of its blood supply.
  • Osteoarthritis: Secondary to joint trauma.
  • Sciatic nerve injury: Due to its proximity to the hip joint.
  • Recurrent dislocation.
Prognosis:
  • Depends on the promptness of reduction, extent of injury, and associated injuries.
  • Early reduction minimises the risk of complications.

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