What Is the Reduction of a Posterior Hip Dislocation?

The reduction of dislocation is a procedure to manipulate the bones back to their normal position. If this is performed externally, i.e., without opening the hip, it is known as a closed reduction.

The hip is a ball-and-socket joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thigh bone).

When there is a hip dislocation, the femoral head is pushed either backward out of the socket or forward.

In approximately 90% of patients with a hip dislocation, the thigh bone is pushed out of the socket in a backward direction. This is called a posterior dislocation.

The adult hip joint is remarkably stable. It typically takes a major force to dislocate the hip or the presence of an underlying condition.

The most common cause of hip locations includes car collisions and falls from extreme heights that exert a tremendous forceful impact on the hip.

Following factors put you at a high risk of hip dislocation:

• Elderly patients: Due to osteoporosis, a minor trauma also can dislocate the hip.
• Ehlers–Danlos syndrome or Down syndrome: Certain diseases that occur by birth can make you prone to get a hip dislocation even by minor trauma.
• Snowboarding: Extreme sports such as snowboarding can dislocate your hip.
• Total hip arthroplasty: Replacement of the damaged hip bone with an artificial implant (prosthesis) can lead to hip dislocation.

A hip dislocation is very painful. Patients are unable to move the leg, and if there is nerve damage, they may not have any feeling in the foot or ankle area.

Your doctor will be able to diagnose a posterior hip dislocation by looking at your hip. A posterior dislocation will make your lower leg fixed, and your knee and foot rotated will be rotated toward the opposite limb of your body.

Your doctor will order X-rays of your hip and legs in different positions to confirm his/her diagnosis and to check if there is any associated fracture.

When the hip dislocates, the ligaments, muscles, cartilage, and nerves holding the bones in place are often damaged. The risks of hip dislocation are as follows:

• Nerve injury: Injury to the sciatic nerve, which passes through your hip, may cause weakness and pain in your lower leg.
• Osteonecrosis: Damage to the blood vessels around the hip may lead to the decreased blood supply to the hips and damage your hip gradually.
• Arthritis: Injury to the protective cartilage around the hip leads to hip arthritis.

A hip dislocation is a serious medical emergency requiring immediate treatment—within six hours of the injury. Depending upon the injury, a hip dislocation can be fixed either by a closed reduction or open reduction.

The reduction of dislocation is a procedure to manipulate the bones back to their normal position. If this is performed externally, i.e., without opening the hip, it is known as a closed reduction. The doctor will administer an anesthetic or a sedative before performing a reduction.

If a hip dislocation is associated with deep injuries and fracture of bones, the reduction will be done in the operating room with general anesthesia, which makes you sleep throughout the procedure. This technique is called open reduction as your hip is surgically opened for the reduction.

Following reduction, the surgeon will ask for a repeat of an X-ray of your hip and possibly a computed tomography (CT) scan to make sure that the bones have been restored to their correct position.

• It takes overall three to four months for the healing of after reduction of hip dislocation. Only then you will be able to resume all your normal activities as before.
• Crutches will be needed for some weeks to allow minimum pressure on your hips while walking.
• Physical therapy can be initiated once the pain in your hips has disappeared and when you can walk without crutches. This happens usually after four to eight weeks.