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Type:
Educational Exhibit
Keywords:
Musculoskeletal bone, Bones, Emergency, Conventional radiography, CT, Diagnostic procedure, Trauma
Authors:
P. H. Ousema, R. E. Westerbeek; Deventer/NL
DOI:
10.1594/ecr2015/C-2500
Background
Roughly 90 % of THD’s are in the posterior direction.
-In case of a posterior hip dislocation,
the mechanism of injury is usually a high energy trauma where an axial load is applied to the femur with the hip in flexion.
Dashboard traumas are common.
Around 10 % of THD's are in the anterior direction.
-Anterior dislocation occurs with forced abduction with the hip in external rotation.
An uncommon form of hip dislocation is obturator dislocation,
or dislocation in the inferior direction with the femoral head situated in the obturator space.
-Obturator dislocation can occur when the subject falls with both the hip and the knee in flexion.
When there is bilateral hip dislocation with one hip dislocated in the anterior direction and one in the posterior direction,
this is called a "criss cross" dislocation.
Associated injuries with hip dislocation are femur and acetabular fractures,
sciatic nerve injury as well as posttraumatic osteonecrosis of the femoral head due to prolonged disruption of the blood supply.
Quick repositioning of the hip is associated with better clinical outcome after hip dislocation.
It is therefore advised to relocate the hip before making any additional imaging,
such as CT.