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Condition/Disorder Synonym

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  • Developmental dislocation of the hip

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ICD-9-CM Codes

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  • 754.3 Congenital dislocation of hip

  • 754.30 Congenital dislocation of hip, unilateral

  • 754.31 Congenital dislocation of hip, bilateral

  • 835 Dislocation of hip

  • 835.0 Closed dislocation of hip

  • 835.00 Closed dislocation of hip, unspecified site

  • 835.01 Closed posterior dislocation of hip

  • 835.02 Closed obturator dislocation of hip

  • 835.03 Other closed anterior dislocation of hip

  • 835.1 Open dislocation of hip

  • 835.10 Open dislocation of hip, unspecified site

  • 835.11 Open posterior dislocation of hip

  • 835.12 Open obturator dislocation of hip

  • 835.13 Other open anterior dislocation of hip

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ICD-10-CM Codes

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  • Q65.00 Congenital dislocation of unspecified hip, unilateral

  • Q65.1 Congenital dislocation of hip, bilateral

  • S71.009A Unspecified open wound, unspecified hip, initial encounter

  • S73.00 Unspecified subluxation and dislocation of hip

  • S73.006A Unspecified dislocation of unspecified hip, initial encounter

  • S73.016A Posterior dislocation of unspecified hip, initial encounter

  • S73.026A Obturator dislocation of unspecified hip, initial encounter

  • S73.036A Other anterior dislocation of unspecified hip, initial encounter

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Preferred Practice Pattern1

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Key Features

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Description

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  • Disarticulation between the femoral head and acetabulum

  • Can occur as a result of trauma in an adult, or congenital in an infant

  • Severe hip pain

  • Adult presentation

    • Result of traumatic incident often involving force along long axis of femur

    • Typically when the knee is bent (typical to car accident)

    • Resulting in posterior displacement of the femoral head

    • Inability to bear weight on the extremity or move

    • Lower extremity appears shortened

    • Femur in an adducted, internally rotated and slightly flexed position

  • Infant presentation

    • More difficult to detect until child is of ambulatory age

    • Dependent upon observation, imaging, and special tests

    • Developmental dislocation of the hip

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Essentials of Diagnosis

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  • Emergency, usually associated acetabular and femoral neck fracture

  • Adult presentation

    • Patient often has inability to even move the lower extremity (LE).

    • Immediate medical referral warranted via activation of EMS. Diagnosis confirmed with radiography.

  • Infant presentation (developmental hip dislocation)

    • Limitation in hip abduction ROM, observable asymmetry in thigh folds, involved leg appears to be shortened

    • Orthopedic special tests exist for condition

    • Imaging studies could show delayed acetabular development

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General Considerations

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  • Adult dislocation is traumatic event, result of high velocity incident, and warrants immediate medical notification.

    • Dislocation most commonly in the posterior direction.

    • Potential exists for injury to the sciatic nerve.

    • Avascular necrosis

    • Nerve damage

    • Post-reduction neurovascular screening is mandatory.

  • Infant dislocation is developmental and associated with osseous development of the acetabulum and proximal femur.

    • Observations more evident in infant when approaching ambulatory age.

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Demographics

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  • Traumatic is typical for the adult population

  • Developmental dislocation often diagnosed at 3 to 12 months of age

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