DISLOCATION OF HIP

Definition

Dislocation of hip is a condition where the head of the femur (thigh bone) is forced out of its normal position in the acetabulum (hip socket) of the pelvis.

Types

1. Anterior Dislocation

• Occurs when the head of the femur is displaced anteriorly (forward) out of the acetabulum.
• Most common type of hip dislocation.

2. Posterior Dislocation

• Occurs when the head of the femur is displaced posteriorly (backward) out of the acetabulum.
• Less common than anterior dislocation.

3. Central Dislocation

• Occurs when the head of the femur is displaced medially (towards the midline) or laterally (away from the midline) out of the acetabulum.
• Rare type of hip dislocation.

Anatomy

• The hip joint is a ball-and-socket joint formed by the head of the femur and the acetabulum of the pelvis.
• The femoral head is surrounded by a fibrocartilaginous labrum, which provides a deeper socket for the femoral head.
• The acetabulum is covered with cartilage, which allows for smooth movement between the femoral head and the acetabulum.

Mechanism

• Hip dislocation can occur due to a variety of mechanisms, including:
  • High-energy trauma, such as a car accident or a fall from a height.
  • Low-energy trauma, such as a slip or a trip.
  • Degenerative joint disease, such as osteoarthritis.

Clinical Features

• Acute pain in the hip or groin area.
• Limited range of motion in the hip joint.
• Inability to bear weight on the affected leg.
• Deformity of the hip joint.

Investigations

• X-rays: to confirm the diagnosis and assess the extent of the dislocation.
• CT scans: to provide more detailed images of the hip joint and surrounding tissues.
• MRI scans: to assess the integrity of the surrounding soft tissues.

Complications

• Arterial thrombosis or embolism.
• Nerve damage or paralysis.
• Infection or sepsis.
• Osteonecrosis or avascular necrosis.

Management

• Immediate reduction of the dislocation using closed or open techniques.
• Immobilization of the affected leg in a spica cast or a traction device.
• Pain management using analgesics or regional anesthesia.
• Rehabilitation to restore range of motion and strength in the affected leg.

Treatment

1. Closed Reduction

• Attempt to reduce the dislocation using closed techniques, such as manipulation under anesthesia.
• May require the use of sedatives or general anesthesia.

2. Open Reduction

• Perform open reduction and internal fixation using surgical techniques.
• May require the use of internal fixation devices, such as screws or plates.

Homoeopathic Therapeutic Approach

• Arnica Montana: to reduce pain and inflammation.
• Hypericum: to reduce nerve pain and inflammation.
• Rhus Toxicodendron: to reduce stiffness and improve range of motion.
• Calendula: to promote healing and reduce inflammation.

Homoeopathic Medicines

• Arnica Montana: 6C, 30C, or 200C potency.
• Hypericum: 6C, 30C, or 200C potency.
• Rhus Toxicodendron: 6C, 30C, or 200C potency.
• Calendula: 3C, 6C, or 30C potency.