International Journal of Physical Medicine & Rehabilitation
Open Access

Long-Term Treatment and Rehabilitation After Hip Dislocation

Vincenzo Binuo Latica^{* *}Correspondence: Vincenzo Binuo Latica, Department of Orthopaedic, University of Florence, Florence, Italy, Email:

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Description

Hip dislocation is a traumatic injury that occurs when the head of the femur (thigh bone) is forced out of its socket in the pelvic bone. It can result from various accidents, falls, or sports-related injuries, and it is a condition that requires prompt and effective treatment. In this article, we will explore the different aspects of hip dislocation treatment, including its causes, diagnosis, immediate care, and the steps towards a full recovery.

Understanding hip dislocation

Hip dislocation can be categorized into two main types:

Posterior dislocation: In this type, the femoral head is pushed backward and out of the hip socket.

Anterior dislocation: In an anterior dislocation, the femoral head is forced forward, causing it to slip out of the acetabulum (the socket in the pelvic bone).

The causes of hip dislocation are typically related to high-energy trauma, such as car accidents, falls from a significant height, or sports injuries. Older individuals may also be susceptible to hip dislocation during a fall due to weakened bones, a condition often linked to osteoporosis.

Diagnosis of hip dislocation

Diagnosing hip dislocation usually involves a thorough examination by a healthcare professional, along with the use of  diagnostic imaging techniques. The signs and symptoms of hip dislocation may include:

• Severe pain in the hip and groin area

• Inability to move the leg or bear weight on it

• The leg may appear shorter than the non-affected leg

• The leg may be turned outward or inward

• Swelling and bruising around the hip

• An audible "pop" or "snap" at the time of injury

Medical professionals will use X-rays and possibly other imaging methods like CT scans or MRI to confirm the diagnosis and assess the extent of damage. Once the diagnosis is confirmed, the focus shifts to immediate care and treatment.

Immediate care for hip dislocation

The initial management of hip dislocation is crucial for preventing further damage and ensuring a better outcome. The following steps should be taken immediately:

Immobilization: The patient should be kept as still as possible.  Attempting to move the leg may cause additional harm. In some cases, traction may be applied to the leg to help keep it in the current position.

Pain management: Pain relief is essential. Administering pain medication, such as Non-Steroidal Anti-Inflammatory drugs (NSAIDs) or stronger prescription painkillers, can provide some relief. However, these should only be administered under medical supervision.

Transportation to the hospital: The patient must be transported to the nearest hospital or medical facility as quickly as possible. Emergency Medical Services (EMS) or an ambulance should be contacted for professional care during transit.

Reduction of the dislocation: In the hospital, the medical team will perform a reduction, which is the process of putting the hip back into its socket. This is a delicate and often painful procedure that requires sedation or anesthesia.

Post-reduction evaluation

Following the successful reduction of the hip, the medical team will conduct a thorough evaluation to ensure there is no damage to blood vessels, nerves, or other structures in the area. This evaluation is crucial because untreated complications can lead to long-term issues and even limb-threatening conditions.

Long-term treatment and rehabilitation

The treatment and rehabilitation process following hip dislocation depends on various factors, including the type of dislocation, the extent of associated injuries, and the overall
health of the patient. Here's a general outline of the long-term treatment and recovery process:

Immobilization: After reduction, the hip is typically immobilized using a splint, brace, or hip abduction orthosis.

This helps in maintaining the reduction and providing support to the healing joint.

Pain management: Pain management continues throughout the recovery process, with medications and physical therapy as needed.

Physical therapy: Physical therapy is a crucial aspect of hip dislocation recovery. Under the guidance of a physical therapist, patients will begin with gentle exercises to regain strength and mobility in the affected hip. Over time, these exercises will become more intense and focused on improving the hip's functionality.

Weight-bearing progression: The patient will gradually start bearing weight on the affected leg as their condition improves. The timeline for this varies depending on the patient's progress and the extent of the injury.

Follow-up appointments: Regular follow-up appointments with orthopedic specialists are essential to monitor the healing process, make adjustments to the treatment plan, and address any concerns or complications.

Complications and risks

Hip dislocation is a serious injury that can lead to complications, even after proper treatment. Some potential complications include:

Avascular necrosis: Avascular necrosis, or the death of bone tissue due to reduced blood flow, can occur as a result of hip dislocation and its treatment. It may necessitate further surgical intervention.

Post-traumatic arthritis: Damage to the hip joint during dislocation can lead to post-traumatic arthritis, a condition characterized by pain and stiffness in the joint.

Nerve or blood vessel damage: In severe cases, nerve or blood vessel damage can occur, potentially leading to permanent disability or amputation.

Recurrent dislocations: There is a risk of recurrent dislocations in some cases, especially if the hip joint is not stabilized adequately during the initial treatment.

Prevention

Preventing hip dislocation primarily involves taking precautions to avoid situations that could lead to high-impact injuries. This includes:

• Using appropriate safety equipment during sports activities.

• Paying attention of the surroundings to avoid slip and fall accidents.

• Addressing underlying medical conditions like osteoporosis to reduce the risk of fractures.