Dislocation: Hip (and nerve lesions) Flashcards
Most common cause of hip dislocation?
Direct trauma (especially RTA, falls from height)
Types of hip dislocation?
Posterior (90%)
Anterior (10%)
Central
How do posterior hip dislocations present?
Shortened + ADDucted + INTernally rotated
no weight bearing due to severe pain
How do anterior hip dislocations present?
No shortening + ABducted + EXTernally rotated
Immediate Mx of hip dislocations?
ABCDE
Analgesia
Reduction under GA <4h (AVN risk)
Long-term Mx of hip dislocations?
Physiotherapy - strengthens surrounding muscles
Comps of hip dislocations?
Sciatic or femoral nerve injury
AVN
Osteoarthritis (esp if older)
Recurrent dislocation
Why might hip dislocations recur?
Due to initial damage to supporting ligaments
Prognosis of hip dislocations?
2-3 months for hip to heal after traumatic dislocation
When is prognosis best for hip dislocations?
Hip is reduced <12h post-injury
Minimum joint damage
How does posterior hip dislocation cause sciatic nerve injury?
Femoral displacement stretches/damages sciatic nerve behind
Signs and Sx of a sciatic nerve lesion?
Posterior thigh sensory deficit
Posterolateral leg sensory deficit
Foot drop
Signs and Sx of a femoral nerve lesion?
Anteromedial thigh and leg sensory deficit
Weak hip flexion
Weak knee extension
Signs and Sx of an obturator nerve lesion?
Weak thigh adduction
Anterior/medial thigh sensory deficit
Signs and Sx of a pudendal nerve lesion?
External genitalia sensory deficit
Bladder and bowel dysfunction
