Fractures and Dislocations at The Hip Joint 2 (2) 3333

Fractures and
dislocations at the
hip joint
Huda Yosef Alhashem
Shahad Adel Alhemaid
Danah Zaki Al-Abbas
Reham
Specific Objectives:
1. give an outline of the hip joint

2. Describe dislocation of the hip joint
3. Describe fractures of the neck of the femur
01
outline of the
hip joint
Hip Joint
- Ball and socket synovial joint
Forming the connection between the lower
limb and the pelvic girdle
- It is comprised of two bones: the

thighbone or femur, and the pelvis,
which is made up of three bones called
ilium, ischium and pubis.
- The hip joint is also multi-axial meaning

that it rotates more than one axis which
allows for a wider range of movement
-The hip joint is designed for stability and

weight bearing
Hip Joint
- Both the lunate surface of the
acetabulum and the head of the
femur are
covered by hyaline cartilage with
the exception of the fovea capitis
femoris.
- Also we call it
(acetabulofemoral joint)
- Joint capsule: strong fibrous

capsule.
Blood supply
- medial and
lateral
circumflex
femoral
arteries
which arise
from deep
femoral
artery .
- Artery to
head of femur
branch of
obturator
artery.
02
dislocation of
the hip joint
Hip Dislocation
● A traumatic hip dislocation occurs when the head of the femur is
forced out of its socket in the hip bone (pelvis).
● It typically takes a major force to dislocate the hip. Car accidents and
falls from significant heights are common causes and, as a result,
other injuries like broken bones often occur with the dislocation.
● A hip dislocation is a serious medical emergency.
Hip Dislocation
● Nerve injury.
As the femur is pushed out of the socket, particularly in posterior
dislocations, it can crush and stretch nerves in the hip. The sciatic
nerve, which extends from the lower back down the back of the legs,
is the nerve most commonly affected. Injury to the sciatic nerve may
cause weakness in the lower leg and affect the ability to move the
knee, ankle and foot normally.
● Osteonecrosis.
As the femur is pushed out of the socket, it can tear blood vessels.
When blood supply to the bone is lost, the bone can die, resulting in
osteonecrosis.
● Arthritis.
The protective cartilage covering the bone may also be damaged,
which increases the risk of developing arthritis in the joint.
Description
Posterior Dislocation Anterior Dislocation
In approximately 90% of hip When the femur slips out

dislocation patients, the femur of its socket in a forward
is pushed out of the socket in a direction.
backward direction.
A posterior dislocation leaves The hip will be bent, and

the lower leg in a fixed the knee and foot will
position, with the knee and rotate out and away from
foot rotated in toward the the middle (externally
middle (internally rotated) of rotated) of the body.
the body.
Description
Posterior Dislocation Anterior Dislocation
Adducted Abducted
Internally rotated Externally rotated

Symptoms of hip dislocation
Inability to move
01 Acute pain. 02 Muscle spasms. 03 your leg.
Leg is rotated Hip is visibly out Inability to bear

04 inward or outward. 05 of place. 06 weight on your leg.
Loss of feeling in
07
Swelling or discoloration
at your hip joint. 08 your hip or foot.
if there is nerve damage, they
may not have any feeling in
the foot or ankle area.
How is a hip dislocation examination?
When hip dislocation is the only injury, an orthopedic surgeon can
often diagnose it simply by looking at the position of the leg.
Because hip dislocations often occur with additional injuries, however,
its important to complete a thorough physical evaluation.
you should do imaging tests, such as X-rays and likely a CT scan, to

show the exact position of the dislocated bones, as well as any
additional fractures in the hip or femur.
hip dislocation examination?
X-ray CT scan
Treatment of hip dislocation
reduction Surgical Treatment

a manipulate the bones
back into their proper
position. This is called a
reduction.
Reduction Procedures
If there are no other injuries, you should give the
patient anesthetic or a sedative, and a manipulate
the bones back into their proper position.
In some cases, the reduction must be done in the

operating room with anesthesia. In rare cases, torn
soft tissues or small bony fragments block the femur
from going back into the socket. When this occurs,
surgery is required to remove the loose tissues and
correctly position the bones.
Following reduction, will request another set of X-

rays, and possibly a computed tomography (CT) scan,
to make sure the bones are in the proper position.
Surgical Treatment
Surgical treatment may be required if there are fractures associated with the
dislocation, or if the hip is unstable even after reduction.
The goals of surgery are to restore hip joint stability and to restore the cartilage
surfaces to their normal positions. Typically, this requires a large incision, and the
surgery may result in a lot of blood loss. Patients may require a blood transfusion
during or after this surgery.
03
fractures of
the neck of the
femur
Femoral neck fracture
is a specific type of intracapsular hip
fracture. (occurs within the capsule of the
hip joint )
The femoral neck connects the femoral
shaft with the femoral head.
• The femoral neck is the weakest part

of the femur
• The junctional location makes the
femoral neck prone to fracture.
• The blood supply of the femoral head
runs along the femoral neck and is an
essential consideration in displaced
fractures.
Neck of femur fractures caused
either by:
• low energy injuries (the most common type)
such as a fall in frail older patient,
• high energy injuries, such as a road traffic
collision or fall from height and are often
associated with other significant injuries.
Risk factors includes:

•Osteoporosis
•Elderly
•Female gender
•Decrease mobility .
Anatomical Clssfication
Pauwels Clssfication
Classified according to the angle of

the fracture line from horizontal
•Type I: between 0 and 30 degrees

•Type II: between 30 and 50 degrees
•Type III: more than 70 degrees
• he more vertical the fracture the

more shear force = the more
complication rate. Stable Less Stable Unstable
Garden Clssfication
according to the degree of displacement as seen on an AP radiograph:
Garden Simplified
Classification Classification
Description
I Incomplete fracture but nondisplaced

Non-
displaced
II Complete fracture but nondisplaced
III Complete fracture, partial displacement

Displaced
IV Complete fracture fully displaced
• In general, Garden stage 1
and 2 are stable fractures
and can be treated with
internal fixation (head-
preservation)
stage 3 and 4 are unstable

fractures and hence
treated with arthroplasty
(either hemi- or total
arthroplasty)
Anatomy Summary fractures of the
neck
-Ball and socket synovial joint
Hip dislocation - Femoral neck is the
- thighbone or femur, and the
weakest part of the
pelvis. femur.
1. Hip dislocation is a serious
- Fracturs of femoral neck
-The hip joint is also multi-axial. medical emergency occurs when
is most common In :
the head of the femur is forced out elderly patient
-The hip joint is designed for of its socket in the hip bone. Causes:
stability and weight bearing
1- Low energy injuries
2. Hip dislocation could be 2- High energy injuries
-Attached to three main
posterior dislocation or anterior Classifications:
ligmants Iliofemoral ligament,
dislocation. 1-anatomy
Pubofemoral ligament and 2- Garden
Ischiofemoral ligament. Some symptom: Acute pain, muscle 3-Pawels
Treatment:
- Supplied by medial and spasms, Inability to move leg
Fixation
lateral circumflex femoral arthroplasty (either hemi- or
Examin by x-ray & CT Scan
arteries, artery of ligamentum total arthroplasty)
teres Treatmen: rediction or surgical
Thank you
Resources
Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/22222-hip-dislocation
Orthoinfo:https://orthoinfo.aaos.org/en/diseases--conditions/hip-dislocation/
https://teachmeanatomy.info/lower-limb/bones/femur/
https://faculty.washington.edu/jeff8rob/trauma-radiology-reference-resource/10-pelvis-
hip/garden-classification-of-femoral-neck-fractures/
https://radiology.expert/x-hip/pathology/proximal-femoralfractures/
Medical Infographics
...and our sets of editable icons
You can resize these icons without losing quality.
You can change the stroke and fill color; just select the icon and click on the paint bucket/pen.
In Google Slides, you can also use Flaticon’s extension, allowing you to customize and add even more icons.
Educational Icons Medical Icons

Fractures and Dislocations at The Hip Joint 2 (2) 3333

Uploaded by

Copyright:

Available Formats

Fractures and Dislocations at The Hip Joint 2 (2) 3333

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Fractures and Dislocations at The Hip Joint 2 (2) 3333

Uploaded by

Copyright:

Available Formats

Fractures and

1. give an outline of the hip joint

- It is comprised of two bones: the

- The hip joint is also multi-axial meaning

-The hip joint is designed for stability and

- Joint capsule: strong fibrous

In approximately 90% of hip When the femur slips out

A posterior dislocation leaves The hip will be bent, and

Internally rotated Externally rotated

Leg is rotated Hip is visibly out Inability to bear

you should do imaging tests, such as X-rays and likely a CT scan, to

reduction Surgical Treatment

In some cases, the reduction must be done in the

Following reduction, will request another set of X-

• The femoral neck is the weakest part

Risk factors includes:

Classified according to the angle of

•Type I: between 0 and 30 degrees

• he more vertical the fracture the

I Incomplete fracture but nondisplaced

III Complete fracture, partial displacement

stage 3 and 4 are unstable

You might also like