Dislocation of the hip: A review of types, causes, and treatment

Abstract

Background: Dislocation of the hip is a well-described event that occurs in conjunction with high-energy trauma or postoperatively after total hip replacement. Methods: In this review, the types, causes, and treatment modalities of hip dislocation are discussed and illustrated, with particular emphasis on the assessment, treatment, and complications of dislocations following total hip replacement. Results: Hip dislocations are commonly classified according to the direction of dislocation of the femoral head, either anterior or posterior, and are treated with specific techniques for reduction. Generally, closed reduction is the initial treatment method, usually occurring in the emergency room. Bigelow first described closed treatment of a dislocated hip in 1870, and since then many reduction techniques have been proposed. Each method has unique advantages and disadvantages. Anterior hip dislocation is commonly reduced by inline traction and external rotation, with an assistant pushing on the femoral head or pulling the femur laterally to assist reduction. Posterior hip dislocations are the most common type and are reduced by placing longitudinal traction with internal rotation on the hip. Conclusion: Patients with hip dislocations must receive careful diagnostic workup, and the treating physician must be well versed in the different ways to treat the injury and possible complications. Timely evaluation and treatment, including recognizing the potential complications, are necessary to offer the best outcome for the patient.