Hip dislocation or subluxation may appear in a wide range of settings: it may result from traumatic injury, atraumatic capsular laxity, structural bony abnormality (such as acetabular dysplasia) and iatrogenic injury. Traumatic hip dislocations, most often caused by motor vehicle accidents or similar high-energy impacts, traverse a large subset of distinct injury patterns. Non-surgical treatment is often recommended if no other associated injuries occurred while surgical treatment may be required in selected cases and may be performed arthroscopically or trough open surgery. Dislocation may also occur after a minor trauma; in those cases often a predisposing anatomy is the leading cause of the instability. Treatment is controversial in those scenarios but surgeon should evaluate the femoral and acetabular anatomy and, if indicated, offer its possible correction such as periacetabular osteotomy and/or femoral osteotomy. Atraumatic subluxation of the hip is often present in patients with developmental dysplasia of the hip. The latter involves a spectrum of hip disorders that affect hip anatomy and development and can range from mild anatomical deformity with a reduced but subluxable hip to a frankly dislocated hip. Eventually hip dislocation or subluxation may occur after surgical procedure and they have been reported after either hip arthroscopy either open procedures. In those cases, treatment is controversial and often ends in a total hip replacement. In this chapter, the patterns of dislocation and subluxation are reviewed and their associated issue are described in order to allow surgeons to provide optimal care for these patients.
Hip dislocation: Types, causes and treatments
Aprato A.;Nardi M.;Cominetti G.;Zoccola K.;Masse A.
2018-01-01
Abstract
Hip dislocation or subluxation may appear in a wide range of settings: it may result from traumatic injury, atraumatic capsular laxity, structural bony abnormality (such as acetabular dysplasia) and iatrogenic injury. Traumatic hip dislocations, most often caused by motor vehicle accidents or similar high-energy impacts, traverse a large subset of distinct injury patterns. Non-surgical treatment is often recommended if no other associated injuries occurred while surgical treatment may be required in selected cases and may be performed arthroscopically or trough open surgery. Dislocation may also occur after a minor trauma; in those cases often a predisposing anatomy is the leading cause of the instability. Treatment is controversial in those scenarios but surgeon should evaluate the femoral and acetabular anatomy and, if indicated, offer its possible correction such as periacetabular osteotomy and/or femoral osteotomy. Atraumatic subluxation of the hip is often present in patients with developmental dysplasia of the hip. The latter involves a spectrum of hip disorders that affect hip anatomy and development and can range from mild anatomical deformity with a reduced but subluxable hip to a frankly dislocated hip. Eventually hip dislocation or subluxation may occur after surgical procedure and they have been reported after either hip arthroscopy either open procedures. In those cases, treatment is controversial and often ends in a total hip replacement. In this chapter, the patterns of dislocation and subluxation are reviewed and their associated issue are described in order to allow surgeons to provide optimal care for these patients.
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