[5] Hip dislocations are a medical emergency, requiring prompt placement of the femoral head back into the acetabulum (reduction).
[9] This reduction of the femoral head back into the hip socket is typically done under sedation and without surgery, through maneuvers including traction on the thighbone in line with the dislocation.
[11] Typically, people with hip dislocations present with severe pain and an inability to move the affected leg.
[8] To note, Central dislocation is an outdated term for displacement of the femoral head towards the body's center into a fractured acetabulum and is no longer used.
[4][5][16] This is to say, the affected leg will be bent upwards at the hip, while being shifted and pointed towards the middle of the body.
[11][17] Sciatic nerve injury is also present in 8%-20% of cases, conferring numbness and weakness to aspects of the lower leg.
[4][5][13] This is to say that with superior and inferior anterior dislocations, the affected leg will be bent at the hip backwards and upwards respectively, while being shifted and pointed away from the body.
[16] The hip joint includes the articulation of the spherical femoral head (of femur) and the concave acetabulum (of pelvis).
It forms a ball-and-socket joint that is encased by an articular capsule, reinforced and stabilized by muscle, tendon, and ligaments.
[5] About 65% of cases are related to motor vehicle collisions, with falls from elevation and sports injuries causing the majority of the rest.
[5] Moreover, wear and tear of the body with aging increases the older population's susceptibility to hip dislocation.
[21] Posterior dislocations happen with direct trauma to a bent (flexed) knee as is the case with a dashboard injury in a motor vehicle accident.
[citation needed] Anterior dislocations happen with trauma forcing external rotation and abduction of the hip.
[4] This is done through manual traction of the thigh inline with the dislocation under general anesthesia and muscle relaxation, or conscious sedation.
It is important to understand that each individual has different capabilities that can best be assessed by a physical therapist or medical professional, and that these are simply recommendations.
[29]Hip dislocations can take anywhere from 2–3 months to fully heal, and even longer depending on associated injuries such as fracture.
[4] Anterior dislocations are noted to have worse outcomes with their higher likelihood of being associated with femoral head injuries.
[4] Femoral head osteonecrosis happens in 5-40% of dislocations, with rates rising the longer time to reduction (>6 hours).
[3] Most common cause is high energy trauma such as from a motor vehicle collision or a high-level fall.