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Hip Dislocation

 

            Hip dislocations are an orthopaedic emergency due to the vast amount of trauma that can be caused to the neurovascular system that correlates to the hip. JA is an eighteen-year-old male patient who was consulted at Wilkes Barre General ER on August 11, 2003. JA was at football practice and was hit by another football player in the area of his anterior hip. JA felt his hip "pop out" and fell to the ground immediately in pain. JA was unable to get up, bear weight, or walk on his leg after the injury. An ambulance was called and he was brought to the ER. JA denies any numbness or tingling in his lower right extremity, inferior to his injury. He has good sensation to light touch in his lower right extremity and his skin is warm and pink. There is a palpable pedal and popliteal pulse. JA reports a similar injury four months prior for which he was treated at CMC hospital in Scranton. At that time he was diagnosed with a posterior hip dislocation, which was reduced, and he was discharged. He was released to play football by his orthopaedic doctor. X-rays demonstrate a posterior hip dislocation with fracture of the superior rami of the pelvis on the right side. There also appears to be an old fracture in this same area. CT confirmed the presence of both a new and old fracture of his superior rami of his pelvis. JA was sedated using Versed and Demerol. Once the medication had taken full effect, his hip was reduced using counterforce traction while stabilizing the pelvis. Post reduction x-rays show the femoral head in good alignment within the acetabulum. JA reported immediate alleviation of pain with reduction. He was then transferred to CMC for further evaluation and treatment of his pelvis fracture. .
             Hip dislocations are not common in athletes due to the great amount of force required to cause such an injury. Only 3% of all hip dislocations are sports related. The majority of all hip dislocations are the direct cause of motor vehicle accidents.


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