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  • Developmental dislocation of the hip

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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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  • 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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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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Signs and Symptoms

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  • Adult prior to reduction
    • Patient has inability to move hip or bear weight.
    • Hip appears shortened and in an adducted, internally rotated, and slightly flexed ...

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