ABSTRACT
Hip dislocations are high-energy injuries, occurring in conjunction with femoral fractures or polytrauma in 40–75% of cases. In an isolated posterior hip dislocation, the leg is shortened and lies adducted, internally rotated and slightly flexed. Anteriorly dislocated hips are more difficult to reduce than posteriorly dislocated hips. The leg is gently internally and externally rotated until the hip reduces – for superior dislocations, pressure anteriorly over the palpable femoral head may assist. Anteroposterior and lateral X-rays of the hip allow diagnosis of the fracture in the majority. If pathological lesions are suspected, views of the whole femur must be obtained. Proximal fractures are also difficult to control and all require regular X-rays, adjustment and physiotherapy to prevent joint stiffness. Skeletal traction through the proximal tibia may be suitable with transition to a cast brace or range of motion brace as soon as pain settles and fracture stability has improved.
