Hip dislocation

Introduction Dislocation of the hip is a serious injury because the hip joint is structurally stable and must have a strong external force to cause dislocation. Soft tissue damage is also severe at the time of dislocation. And often combined with other parts or multiple injuries. Therefore, the patients are mostly young adults with strong activities. Generally divided into three types of front, back and center dislocation. After dislocation, the femoral head was located on the Nelaton line (the anterior superior iliac spine and the ischial tuberosity line) before the dislocation. After the off-line is the posterior dislocation, the femoral head is squeezed to the midline, and the person who breaks the acetabulum and enters the pelvis is dislocated. Later dislocations are the most common of the three types. This injury should be treated as an emergency, and the earlier the reset, the better the effect.

Cause

The disease is caused by external force and dislocation. Dislocation is divided into three types: anterior and posterior dislocation and central dislocation. Later dislocation is the most common.

1. Post dislocation: The posterior dislocation is due to the flexion and adduction of the hip joint, and the violence from the long axis of the femur can tear the ligament, and the femoral head breaks through the joint capsule and causes dislocation.

2. Center dislocation: If the hip joint is in flexion and mild internal fixation, the same external force can cause the posterior margin of the acetabulum to fracture and the femoral head to dislocate backward. If the hip joint is in the middle or mild outreach position, violence can cause acetabular fractures, and the femoral head is displaced along the fracture to the pelvic cavity, which is called central dislocation, which is rare.

3, the former dislocation: If the hip joint is in the outreach position, the femur large trochanter and the upper edge of the acetabulum collide, as this fulcrum continues to abduction, violence along the long axis of the femoral head impact, can occur before dislocation. The femoral head can stay in the closed hole or the pubic humerus. For example, in the lower jaw position, the legs are abducted, and the kiln hole collapses, and the anterior dislocation can also occur.

an examination

Related inspection

One-leg standing test, sputum tension test, fist test, infant musculoskeletal system, synovial fluid, visual inspection

X-ray inspection

X-ray plain film is the most basic method for diagnosing hip dislocation and fracture. Most of the dislocation X-ray films can be correctly displayed.

2. CT examination

It can make a correct diagnosis for most hip dislocations. The advantage of X-ray film is that it can clearly show the direction and extent of dislocation. More importantly, it can clearly and accurately show whether there are broken bone fragments in the hip joint. The existence of the three-dimensional reconstruction of CT has the greatest advantage of stereoscopically displaying the surface of the joint, the image is realistic, and the image can be rotated at any angle to obtain the best exposed portion.

Differential diagnosis

1. Hip dysplasia: Hip dysplasia refers to the problem of the hip joint of an infant or child not caused by injury, complications of infection, various muscle paralysis or other neuropathy.

(1) Hip dysplasia.

(2) Hip subluxation.

(3) The hip joint is completely dislocated.

2, hip joint effusion: hip joint effusion is one of the clinical diagnosis of hip joint synovitis.

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