It is essential to obtain specialized help as soon as possible in these cases in order to avoid further damage.
A dislocation or hip dislocation is a pathology. This consists of a loss of the normal joint relationship between the joint surface of the femur and the pelvis. There are different types of hip dislocations. These depend on where the joint surface of the femur lies with respect to the tibia.
In this way, we distinguish between two types of hip dislocation :
- Anterior hip dislocation : the femur is above the acetabulum , that is, the concave articular portion of the pelvic surface.
- Posterior hip dislocation : the femur is behind the acetabulum.
Hip dislocation is usually due to severe trauma resulting, for example, from traffic accidents. Another frequent cause is high-impact work in which the hip suffers a sharp and sudden blow.
For example, when a co-pilot is involved in a car accident by hitting his knee against the board. In this case, the clinic would show a leg with internal rotation, abduction and a flexed leg.
The symptoms produced by hip dislocation are:
- Pain around the hip.
- Functional impotence : inability to rotate the leg when performing an external or internal rotation, depending on whether the dislocation is anterior or posterior.
- Shortening of the limb and deformity in case of not receiving the necessary medical attention.
The diagnosis of a hip dislocation does not usually require special tests . This is due to two factors:
- The patient presents intense pain around the hip.
- The leg is immobilized and with external or internal rotation if it is anterior or posterior respectively.
However, it is advisable to perform an image test of the area . In this way, the existence of a fracture of the bone associated with the dislocation is discarded before trying to manipulate it:
- A radiological examination of the two planes is sufficient to know the type of dislocation and perform the appropriate treatment. If the radiography is not enough, it would be necessary to perform a scan (CAT) to check if there is displacement of the ligaments or fracture.
- A CAT (computerized axial tomography) is an imaging technique that uses X-radiation to obtain cuts or anatomical sections, in this case the hip and thus give a diagnosis. In the diagnosis of hip dislocation, the simple CT scan and the three-dimensional CT scan are used.
To prevent further serious injury, treatment for a hip dislocation should be started as soon as possible. This treatment consists of reducing the articulation, that is, repositioning it in its natural position .
In general, the placement of the hip is performed is carried out with local anesthesia , in order to maintain previously relaxed muscles with analgesics and anesthetics. Only general anesthesia will be used as a last resort, when in spite of the medication, the joint can not be reduced without risk of causing more damage.
Once the joint is reduced, a control X-ray should be performed to rule out fractures associated with the dislocation. Next, the leg is immobilized so that it is attached to the bandage. The usual thing is that during the time that the leg is immobilized the patient is not allowed to rest the foot on the floor or to continue getting out of bed.
Once the resting time has passed, rehabilitation exercises are essential . This is because with them the strength of muscles weakened by immobilization is recovered. Although it is normal to lose agility and strength after dislocation, a full recovery after it is also common.
Directed by a physiotherapist, stretching exercises and muscle toning like fitball and bosu are beneficial, favoring the recovery of muscle strength.
If immediate medical attention is not available, appropriate first aid may be put into practice to treat dislocations:
- It is necessary to immobilize the affected joint , that is, the hip.
- To produce an analgesic effect , apply ice on the hip.
- Do not move the area, it will be necessary an absolute rest to not aggravate the situation.
- Under no circumstances try to reposition the hip, or administer any medication to the affected person.
Once these steps are followed, it will be necessary to transfer the affected person to a medical center. There, the medical staff can carry out the necessary tests.