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<< Managing Dislocations of the Hip, Knee, and Ankle in the Emergency Department (Trauma CME)

Disposition

Hip Dislocation

After any reduction attempts in the ED, the patient’s neurovascular status should be re-evaluated. The affected leg is then immobilized in extension, external rotation, and slight abduction. An abduction pillow or another object can be placed between the knees in order to avoid flexion, internal rotation, and adduction of the hip. The patient may also be placed in a knee immobilizer to prevent inadvertent flexion at the hip.4 Radiographs should be repeated to confirm reduction, followed by a postreduction CT scan if concern exists for an incomplete reduction, occult fracture, or intra-articular loose bodies. A nonconcentric reduction is a surgical emergency due to the pressure on the articular cartilage, even though blood supply may have been restored to the femoral head. The affected hip may require traction and/or open reduction.4

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