Hip joint dislocation - symptoms and treatment

Dislocation of the hip joint in adults - a fairly rare phenomenon, such a pathology occurs in about 5 out of 100 traumatological patients. This fact is explained by the anatomical features of the structure. It is well strengthened by a strong ligamentous apparatus and a dense capsule, in addition it is protected by large, powerful muscles.

For the development of a dislocation, a considerable external force is necessary, under the influence of which there is a rupture round ligament, as well as the synovial pouch of the joint and the loss of the head of the femur from the acetabular cavities.

Depending on the condition of the berthinium (Y-shaped) ligament, one can distinguish:

• correct dislocation, in which this ligament remains intact, which determines in advance the further path of the femoral head;
• irregular, characterized by a complete rupture of the berthinic ligament and the unpredictability of the movement and the final position of the femoral head.

Causes of pathology development

The main causes of dislocation in adults are:

• injuries resulting from road accidents, falls from a great height, natural disasters;
• complication after endoprosthetics;
• not diagnosed in time dysplasia.

Dislocations resulting from various injuries

Depending on the places, which had a traumatic impact, experts identify the following types of dislocations:

1. Rear:
   • iliac or posterior;
   • ischial or posterior.
2. Front:
   • supernumerary or anteroposterior;
   • locking or front.

To provoke the development of such pathology, a strong blow to the thigh, caused at the moment when the person is in a sitting position, more often such situations arise in road transport incidents.

Anterior dislocation can occur when falling on a turned outward leg, with the femur head shifting inward and downward, tearing the anterior part of the synovial capsule. When it leaves the region of the pubic articulation, a dislocated dislocation develops, and in the region of the occlusal aperture it is blocked.

Much less common:

• overturning dislocation, in which the head of the femur is located above the acetabulum;
• suprapubic - respectively, the head of the bone is located above the horizontal branch of the pubic bone;
• perineal - dislocation in the perineal region;
• central - under a strong impact on the large trochanter of the femur, its head emerges into the pelvic region, thus breaking through the wall of the acetabulum.

Can dislocation be a complication after endoprosthetics?

A dislocation of the hip joint is one of the complications most often encountered after an endoprosthetic operation. In most patients, it occurs only once and with correct timely correction no longer repeats.

The factors provoking the development of this pathology include carrying out surgery from the back of the surgical approach and the design features of the endoprosthesis (large cervico-diaphyseal angle).

Dysplasia not diagnosed on time

Not diagnosed in childhood, dysplasia can lead to increased mobility in adulthood. Provocative factors for the development of damage in this situation are professional ballet, gymnastics and other sports.

Clinical manifestations of the disease

For all traumatic manifestations of the disease, the following clinical manifestations are characteristic:

• presence of sharp pain in the thigh;
• changing the length of the limb from the side of the injury;
• change of form;
• impossibility of committing active movements;
• the appearance of springing resistance, soreness and a sharp limitation of passive movements;
• the person takes the forced position of the body.

The rear species are characterized by a position where the leg is turned inward by the knee, is brought to the body and bent at the knee joint. The head of the femur is then palpated under the gluteus muscles or next to the ischium. There may be damage to the sciatic nerve.

In the front type, the leg is bent, bent, deployed outward, the gluteal region is flattened, and the femoral head is defined in the groin fold region. Such dislocations can be accompanied by compression of the vessels of the thigh or damage to the occlusive nerve.

The lack of adequate treatment of dysplasia in childhood can lead to the development of the following secondary changes:

• rachiocampsis;
• violation of the pelvic position;
• subluxation of the hip from the healthy side;
• limb shortening;
• development of a false joint.

Diagnostics

To diagnose the dislocation of a medical examination and a radiographic image in two projections, an MRT can sometimes be prescribed.

Methods of treatment of the disease

Treatment of subluxations

The sign of subluxation of the hip joint is the incomplete displacement of the head of the femur with respect to the acetabulum. Subluxation in adulthood is practically not amenable to therapy, since the position of the bones entering the joint in relation to each other is completely settled.

If necessary, surgical methods of treatment can be prescribed:

• open direction;
• osteotomy;
• palliative operations.

Treatment of dislocation

Treatment consists of several stages:

1. Stage of inpatient treatment- under general anesthesia with the mandatory use of drugs, relaxing muscles (muscle relaxants), a dislocation is performed, after which a skeletal traction is required, which will take from 2 to 4 weeks.
2. Out-patient stage- can last up to 10 weeks, during which a person is allowed to walk only with crutches and physiotherapy and therapeutic gymnastics are prescribed.

A complex of exercises of therapeutic gymnastics for dysplasia in adults or after treatment of dislocation (including with the use of surgical methods) is appointed with the purpose of restoration of a correct configuration and functional activity, strengthening of muscles of a femur and maintenance of a normal blood supply and trophics.Select the exercises and monitor the correctness of their performance should the doctor.

With the timely begun treatment of a hip dislocation, having a traumatic origin practically does not give complications, chronic dislocations can lead to the development of coxarthrosis and subsequent disability. If there is pain in the hip, difficulty walking or increased mobility of the joint, you need to see a doctor in order to exclude the development of pathology.