Hip dislocation - Causes, Symptoms and Treatment .MF .
Hip dislocation - a pathological displacement of the femoral head out of the acetabulum.The hip joint - one of the most protected in the body, it is surrounded by a considerable volume of muscles and strong ligamentous apparatus.Therefore, hip dislocation can occur only under the influence of a significant external force - most often it occurs in an accident or a fall from a height.
Congenital dislocation occurs when severe dysplasia (underdevelopment) of the hip joint.This becomes possible abnormal mobility of the femoral head.Read more about congenital hip dislocation, its symptoms and treatment in "hip dysplasia and congenital dislocation of the hip" & gt; & gt;
In this article, a closer look at traumatic hip dislocation.Traumatic dislocation, as the name implies, is a consequence of the external force.Depending on the direction of its application and the provisions of the limb at the time of the traumatic effects of possible multidirectional displacement of the femur.Thus, the following types of t
• When exposed to a traumatic force to the front bent limb (it happens more often in an accident) comes back dislocation of the hip, which is divided into upper and posterior-posterior-inferior.
• If the injury was inflicted when straightened and slightly deployed posterior limb (a fall from a height, extreme sports) - there is a front hip dislocation with a similar division in the anterior upper and lower front.
Symptoms of hip dislocation
mandatory and the most characteristic of all traumatic dislocations of the hip symptoms are abnormal situation and limit the mobility of the limbs.
In posterior dislocation hip forced position is characterized by bringing the bent inwards and turn (at the back-bottom), or rectified (with rear-dislocation of the upper) limb.
In front limb dislocations deployed outwards and reserved, while similar to posterior dislocation, it can be folded (when the front-bottom) or rectified (with front-top-dislocation).
active movement in the hip joint dislocation with no passive extremely painful and also limited in volume.A characteristic is "springy mobility", when you try to change the position of the limb resistance is felt and it returns to its original state.
Involuntary limb position during hip dislocation
On palpation determined ectopic femoral head, depending on the direction of dislocation, it may be determined in the buttocks or in the groin.
Differential diagnosis for hip dislocation
Hip dislocation is to be distinguished from injuries, subluxations and different femur or pelvis.
• Bruising is characterized by soreness in the hip region, while maintaining the full volume of passive and active movements of significant volume.
• When subluxation symptoms are significantly less retained a small amount of active movements of the limbs.
• Fractures of the femoral neck and acetabulum can mimic hip dislocation, often accompany it.
• Fractures of the femur differ obvious limb deformity, pain at the fracture site, preserving the passive movements of the joints.
• For fractures of the pelvic limbs retain mobility, pain occurs when the pressure on the pelvis.
first aid for suspected hip dislocation
Under no circumstances should one try to straighten yourself dislocation!This can lead to very serious consequences of the complexity reduction of dislocation to torn ligaments, tendons, damaged cartilage of the acetabulum.Any attempt to straighten a dislocated independently lead to longer rehabilitation period.
is vital in the case of pelvic injury urgently call the ambulance or emergency situations.
primarily with suspected hip dislocation is necessary to anesthetize the victim.To do this he injected analgesics (analgin, ketanov, or any other available) intramuscularly.
Next, you need to provide immobilization (immobility) of the damaged limb.If the presence of a special bus (flexible or analogs Diterikhs tires) - is necessary to fix the limb by a bus in the position in which it is located.
If such a tire is not present, it is desirable to produce analogs of scrap materials - sticks, branches, any solid objects required size.Before applying an impromptu bus wrapped with a bandage or clothing, or clothing enclose under the bus.It is also possible to bandage the affected limb to a healthy elastic bandage or ordinary, or by any means, including the clothing of the victim.
on hip projection can put a cold compress.
Self transportation of the victim is highly undesirable.However, if other means to deliver it in the health institution there - must be transported on a solid surface.Confirmation of the diagnosis
delivered to the hospital or emergency room of the victim with suspected traumatic dislocation of the inspections and questioning specialists, palpate the hip area to assumptions about the mechanism of injury and the direction of displacement of the femoral head.
is mandatory x-ray region of the joint in two projections for specifying the type of dislocation and exclusion of concomitant damage to surrounding tissue.
Radiography of hip dislocation
Treatment of hip dislocation
In all cases of traumatic hip dislocation patient requires emergency hospitalization. Methods of treatment of traumatic dislocation depends on its severity and the presence or absence of concomitant soft tissue damage and bone.
When uncomplicated hip dislocation after radiography and clarify the type of dislocation of the patient is transferred to the operating room.Dislocation reduction is performed under general anesthesia, and certainly against the background of the introduction of muscle relaxant (substances that relaxes the muscles).Methods reposition various hip dislocation is markedly different.In general, a reduction of dislocation when the doctor repeated in reverse order effects, which led to the injury.Thus the head of the femur as it repeats its way back to the end in the acetabulum.
When complicated by dislocations often require surgery to suture the torn ligaments and / or setting in place of bone fragments.
is strictly mandatory bed rest in the posttraumatic period.
further tactics of treatment is individual.When uncomplicated dislocations require immobilization for up to three weeks in the future - using crutches for a period of 10 days to two months.With the successful rehabilitation of these terms can be reduced.
If there is collateral damage can be shown to the imposition of the cast, skeletal traction or bone fixation.In such cases, the treatment period may increase significantly.
In all cases, treatment of hip dislocation occurs under constant surveillance by trauma to the implementation of the control of x-ray images, assessing the success of the prescribed treatment, the rate of recovery of joint function and the corresponding correction of the current treatment.
Rehabilitation after hip dislocation
Rehabilitation after traumatic hip dislocation is sufficiently long.In the case of flowing perfectly uncomplicated dislocation, which managed to straighten without surgery, the minimum subsequent confinement to bed - for two weeks.Already during his stay on bed rest in the treatment include physiotherapy (physical therapy), massage and physiotherapy.Such treatment is effective only in the complex.That is pointless to hope that you can have a massage - and the limb restored.
Massage with hip dislocation
Complex rehabilitation begins with a massage.The first sessions are relatively sparing effects - stroking and rubbing, designed to restore blood flow to damaged areas for more effective treatment.Then massage becomes more intense - with kneading techniques and begin physical therapy sessions.
Exercising with hip dislocation
physiotherapy exercises are distributed on the same principle - from simpler to more complex and active.The first sessions of physical therapy aimed at preserving effective blood flow to the muscles to prevent atrophy.Exercises at this stage lungs that do not require active movement.The next step is to join the exercises preservation of mobility in the joint, which requires the execution of a range of active and passive movements - starting with the flexion-extension, and within a few sessions extending the range of motion rotating and driving-diverting.Well and further exercises aimed at restoring full joint work and may include sessions at the gym, walking and even running.
Physiotherapy at hip dislocation
Physiotherapy treatments include magnet therapy, UHF, diadynamic currents, thermal treatments and other types of influences.Specific program of physiotherapy treatment is chosen individually in each case a doctor appropriate profile taking into account the patient's needs and opportunities, medical offices.
prognosis of hip dislocation
prognosis for uncomplicated hip dislocation favorable after the completion of remedial measures comes a full recovery.With timely and high-grade treatment of complicated dislocations can also be a full recovery, but increases the likelihood of degenerative joint diseases (arthritis, arthrosis) in the long-term prognosis.
Ed.doctor traumatologist Savchenko VR