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Hip Dislocation in Emergency Medicine

Background

Traumatic dislocations of the hip are an orthopedic emergency. Although the diagnosis of the common posterior hip dislocation may often be straightforward, the emergent diagnosis and reduction of the dislocation, especially in light of multiply traumatically injured trauma patient, can be challenging. High-energy blunt force trauma is the most common cause, although prosthetic hip joints may dislocate with much less force. Multiple studies have shown that timely reduction plays a significant role in reducing later complications and associated comorbidity. As a result, the routine screening for this injury has been adopted in the evaluation of trauma patients.

Congenital dislocation of the hip also occurs and is termed developmental dysplasia of the hip (DDH). The annual incidence of DDH is approximately 2-4 cases per 1000 births; approximately 80-85% of the affected individuals are girls. Routine screening for DDH includes the Barlow and Ortolani tests, with further tests such as ultrasound for cases prompting concern. The focus of this article is on traumatic dislocations.

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