A hip dislocation occurs when the ball shaped head of the femur (thighbone) pops out of the socket of the pelvis. A traumatic hip dislocation is where the ball of the hip joint is forced out of the socket, generally following a high impact fall, a car crash or sporting or work place injury.
A hip dislocation can result in serious, long-term problems and complications, especially if it is severe and is not appropriately treated within hours of occurrence.
In most cases of a dislocated hip, the femoral head is pushed out of the socket toward the rear (posterior dislocation). Less commonly, the affected ball is forced out forward from the pelvis (anterior dislocation).
The hip is a ball and socket joint. The ball (the femoral head) is located at the top of the femur. The socket (the acetabulum), makes up part of the large pelvis. The ball rotates in the socket, allowing the leg to move backward, forward and sideways. Smooth cartilage surrounds the ball and socket allowing them to glide freely together and protect the joint.
Causes of Hip Dislocation
Hip dislocations are uncommon in a normal hip. The majority of dislocated hips are a result of a high impact, high-energy accident such as a motor vehicle accident or a pedestrian being hit by a car. Less commonly, a dislocation will occur from sporting injuries such as football and rugby or snow sports such as snowboarding or skiing.
In people who have undergone a hip replacement, a fall or an irregular movement may provide enough energy to dislocate the prosthesis.
Symptoms of Hip Dislocation
An undiagnosed pain in your hip can mean a number of things, including hip dislocation. Recognising a dislocated hip can be as easy as looking at the appearance in the mirror and noticing difference in shape and colour. Other symptoms of a dislocated hip may include:
- Severe pain throughout the hip may be experienced up and down the leg
- Dislocation may tear tendons or ligaments in or around the hip or can possibly damage nerves
- Swelling or bruising is an indicator of a dislocation
- A visibly deformed or out of place hip can be a sign of a dislocation
- Uncontrollable muscle spasms can cause more pain through the movements
Diagnosis of a Hip Dislocation
At your appointment, your doctor will begin by asking you how the dislocation occurred and how long it has been hurting. Explain any other symptoms to your doctor that you have experienced and if this has previously happened. Your doctor may also observe how well you can move your hip and leg and monitor any change in pain or numbness as you move it.
Imaging tests such as an X-ray may be suggested by your doctor to get a better understanding of your injury. An X-ray is a painless procedure that will show any broken bones, which are common with dislocations and extra injury to the joint.
Treatment of a Hip Dislocation
Closed reduction
Your doctor may try gentle manoeuvres to help your hip back into its correct position. Depending on how severe the pain and swelling is, you may require a sedative, a muscle relaxant, or, in some cases a general anaesthetic prior to the procedure to help ease any discomfort. After your bones are set back into place, extreme pain should improve almost immediately. Your doctor may order an X-ray following the procedure to check that the bones are in the correct position.
Immobilisation
Once your hip has been reset, your doctor may provide a splint to restrict your leg from moving while it heals for a few days to weeks, depending on the severity of the dislocation.
Medication
Throughout the healing process, you may experience an increased level of pain or discomfort. Your doctor may prescribe pain relief or it can be treated with over-the-counter medication such as ibuprofen or paracetamol. Always check with your doctor and follow the dosage instructions provided.
Rehabilitation
Rehabilitation to restore strength, stability and range of motion to the hip joint is a key step in treating and preventing hip dislocation. A physiotherapist can provide you with exercises to do at home and advise you on positions and movements to avoid further dislocations.
Surgery
In extreme cases, if you have a weak hip joint or ligaments, or suffer from recurring hip dislocations, surgical intervention may be necessary. Surgery is typically a last resort if reduction has failed.
Post-Operative Recovery
It can take up to three months for the hip to heal following a hip dislocation. The rehabilitation time may be longer if there are additional fractures. The doctor may suggest limiting hip motion for several weeks to protect the hip from dislocating again.
Patients typically begin walking with crutches or a walker quickly following treatment. Walking aids, along with physiotherapy help patients regain mobility.
There are steps you can take at home to minimise any discomfort and encourage healing after treatment for a dislocated hip. In the first couple of days during the healing process, apply an ice pack to reduce any inflammation and pain. Following the ice pack, when the inflammation has improved, a hot pad can help relax sore, tense muscles.
Ensure you follow any exercises or advice given to you by the doctor and physiotherapist to ensure for the best possible recovery.
Outlook
Early diagnosis is a key step in treating dislocations. If you feel like you are experiencing pain or showing symptoms, make an appointment with your doctor.
Although it is impossible to entirely prevent a dislocated hip, there are steps you can take to help avoid them. Maintain a healthy lifestyle, avoid drinking and smoking and wear protective gear when playing sport.
Need Help?
If you are experiencing pain in your hip which you think could be caused by a disclocation, you can be seen by a Consultant Orthopaedic Hip Surgeon at One Ashford Hospital, usually within 48 hours. One Ashford Hospital is well placed to see patients with knee injuries from Ashford, Maidstone, Canterbury, Folkestone, Dover and all surrounding villages. To book an appointment, call the hospital direct on 01233 364 022 or email here.
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