Publication Date: December 2017 (Volume 19, Number 12)
CME: This issue includes 4 AMA PRA Category 1 Credits™; 4 ACEP Category I credits; 4 AAFP Prescribed credits; and 4 AOA Category 2 A or 2B CME credits
A 25-year-old man is brought in by ambulance after being involved in a high-speed motor vehicle crash as an unrestrained driver. He is complaining of right hip pain and lower abdominal pain. During his primary trauma survey, you note that his right leg is shortened and internally rotated. You suspect a native hip dislocation and/or fracture and wonder which diagnostic studies you should obtain and whether you should attempt a reduction before consulting orthopedic surgery.
Later that evening, an elderly woman arrives with right hip pain, unable to ambulate. She states, “I was just bending over to put on my shoes when I felt a ‘pop,’ and then I fell to the ground.” She then informs you that she recently underwent right total hip arthroplasty. You notice her right leg appears internally rotated, adducted, and shortened. You suspect a dislocation of her prosthesis and wonder whether you should involve orthopedics or reduce it yourself and, if reduction is successful, whether she can be discharged home.