Dislocation, hip

• Developmental dislocation of the hip

• 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

• 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

• 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Connective Tissue Dysfunction

Description

• 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

Essentials of Diagnosis

• 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

General Considerations

• 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.

Demographics

• Traumatic is typical for the adult population
• Developmental dislocation often diagnosed at 3 to 12 months of age

Signs and Symptoms

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