Hip dislocation

Description:

Dislocations of a hip make about 5% of total quantity of dislocations. As a rule, damage results from considerable, high-speed application of the injuring force: at the road accidents, falling from height, collapses, etc.
The hip joint is formed by a convex head of a femur and a concave surface of an acetabular hollow of a haunch bone. The head of a femur enters an acetabular hollow on 2/3. The area of a hip joint increases at the expense of the hryashcheobrazny fabric located on edge of an acetabular hollow. The joint is kept by the capsule and powerful sheaves.

Classification:

In traumatology lobbies and posterior dislocations of a hip allocate. Front dislocations, in turn, are subdivided on anterosuperior (nadlonny) and anteroinferior (locking), and back – on posterosuperior (ileal) and zadnenizhny (sciatic).
Posterior dislocations of a hip meet approximately by 5 times more often of lobbies.
and – posterosuperior dislocation
– zadnenizhny dislocation
in – anterosuperior dislocation
– anteroinferior dislocation

Hip dislocation reasons:

Dislocations of a hip result from an indirect injury. At the same time the femur acts as the lever influencing area of a hip joint. As a result of intensive influence the head of a femur breaks off the joint capsule, injures sheaves and leaves a joint hollow.
The road injury becomes the reason of posterior dislocation of a hip usually. The mechanism of traumatic influence – sharp rotation or bending of the turned knutra given and the bent leg.
Front dislocation of a hip arises when falling from height on the leg turned knaruzh, taken away and bent more often.

Hip dislocation symptoms:

The patient shows complaints to sharp pain in the field of a hip joint. Forced position of an extremity, deformation of a hip joint, more or less expressed shortening of an extremity on the party of damage is characteristic of all types of dislocations of a hip. The passive movements in a hip joint are painful, sharply limited, are followed by the springing resistance. The active movements are impossible.
Forced position of an extremity is defined by a femur head arrangement in relation to an acetabular hollow. At posterior dislocations the leg of the patient is brought, bent and turned by a knee inside. At zadnenizhny dislocation of a hip deformation of a hip joint is expressed more, than at posterosuperior.
At front dislocation the extremity of the patient is developed knaruzh, taken aside, bent in coxofemoral and knee joints. Anteroinferior dislocation is followed by more expressed bending and assignment of a leg.
At posterosuperior dislocation of a hip the head of a femur is palpated under muscles of buttocks, at zadnenizhny – near an ischium.
Flattening of a rump is characteristic of anterosuperior dislocation. The head of a femur is palpated in the field of an inguinal fold, a knaruzha from a femoral artery. Anteroinferior dislocation is also followed by flattening of area of a buttock. The head is probed knutr from a femoral artery.
The roentgenogram at dislocation of a bedravyvikha of a hip can be followed by a separation of edge of an acetabular hollow and injury of a cartilage of a head of a femur. At zadnenizhny dislocations of a hip the bruise of a sciatic nerve is quite often observed. At front dislocations of a hip the prelum of femoral vessels is possible, at anteroinferior – injury of a locking nerve.
Stale and chronic dislocations of a hip are followed by less expressed clinical symptomatology. Pains in a joint decrease over time. Shortening and deformation of an extremity are compensated for the account of an inclination of a basin and sharp increase in a lordosis (a lumbar bend) of a backbone.
Diagnosis of dislocations of a hip, as a rule, does not cause difficulties in the traumatologist. For specification of provision of a head of a femur and an exception of possible bone damages X-ray inspection in two projections or MRT of a hip joint is conducted.

Treatment of dislocation of a hip:

Treatment of dislocation of a hip provides reposition of a joint in normal situation. Because of a big array of the muscles surrounding a hip joint, the patient feels severe pain. For this reason before reposition he is recommended to make full anesthesia using muscular relaxants: only this way muscles completely will relax.

Doctors set hip dislocation in several ways, among which Kokhera-Kefer, Des Prez-Bigelow and Dzhanelidze-Kollen's ways are considered the most popular.

When dislocation is set, to the patient impose the special extending tire which should be carried about a month.

After removal of the tire it is recommended to undergo a complex of recreational procedures which cornerstone the physical therapy (UVCh, use of diadynamic currents, magnetotherapies), massage, thermal procedures and physiotherapy exercises is. Sometimes also circulation on crutches within ten days is recommended.

Unfortunately, hip dislocation quite often is followed by complications, the most widespread of which is the coxarthrosis – degenerative changes in a hip joint.