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Partial Hip Dislocation: Treatment & Exercises

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  • 0:04 Subluxations
  • 0:54 Treatments
  • 2:18 Hip Arthoscopy
  • 3:34 Exercises
  • 5:36 Lesson Summary
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Lesson Transcript
Instructor: Kaitlin Baker

Kaitlin has taught nursing students and has a master's degree in nursing leaderhsip, as well as a bachelor's degree in English literature.

This lesson will teach you some of the main treatments for partial hip dislocation (aka, hip subluxation). You will also learn about exercises used to help stabilize the hip joint and keep the bones in place.

Subluxations

Think of the hip joint like an ice cream cone. The hip is a ball-and-socket joint made by the acetabulum (cuplike area of the pelvis), and the upper end of the femur (thigh bone). Normally, the ball, or ''ice cream scoop'', fits nicely into the socket, or ''cone.'' But sometimes, this perfect fit is disrupted, usually by a large force, such as a car accident, or by a condition called hip dysplasia, where the joint is unstable. If the ball is completely knocked out of the socket, this is called a hip dislocation. If it is only partly knocked out, this is called a partial hip dislocation, or hip subluxation. Subluxations can cause many of the same complications as hip dislocations, including pain, nerve injury, and arthritis, as well as an increased need for hip replacement.

Treatments

Treatment of a hip subluxation depends on the injury's severity. The priority is to get the ice cream back on the cone (femoral head back in the acetabulum). Then, control pain and inflammation, and finally, stabilize the joint to prevent further subluxations.

Getting the hip joint firmly positioned is a difficult task that demands significant force. The doctor first gives the patient a sedative, then manipulates the bones into place. This process is called a reduction.

Once a doctor ensures that the hip is in place, the patient will usually be told to use the RICE (rest, ice, compression, and elevation) method. Resting the joint involves refraining from bearing weight on it before it has had the chance to heal and stabilize. Ice and compression, as well as elevation of the hip help alleviate swelling.

Patients who have hip dysplasia or chronic dislocation may have instability in the hip joint, making it prone to subluxations and dislocations. Infants with this condition are usually treated with a Pavlik harness (soft brace) that holds the ball firmly in the socket for several months.

Surgical Treatment

At times, surgery will be needed for hip subluxations. This will usually be the case when there is significant damage to the ligaments and tendons surrounding the joint, or if doctors are unable to keep the femur in the acetabulum with reduction or other stabilizing methods. Let's now discuss four main surgical types.

Hip Arthroscopy

Hip arthroscopy is minimally invasive and uses a small camera to show the surgeon the hip socket to help him/her make minor repairs to ligaments, tendons, and cartilage. Arthroscopy is often used in combination with other procedures.

Periacetabular Osteotomy of Ganz

This is the most common and effective surgery for deepening the hole in the ice cream cone (acetabulum) and repositioning the ice cream scoop (femoral head) within it. Periacetabular Osteotomy of Ganz surgeries are only used once the patient's skeletal system is mature (age 15 in boys and age 13 in girls). In this procedure, the hip socket is entirely reset, and the surgeon uses screws to hold the joint in the proper alignment. This surgery can be very effective in relieving pain and improving function.

Femoral Osteotomy

During femoral osteotomies, a less common procedure that realigns the femur into the cup of the acetabulum, the surgeon cuts the bone, corrects the angle of the femur, and uses metal plates and screws to hold it in place.

Hip replacement

As a last resort, hip replacements are reserved for severe cases when other methods of holding the joint in place fail. This involves removing any damaged bone and replacing it with prosthetic materials, usually metal secured in place by plates and screws.

Exercises

Before surgery is needed, healing hip subluxations are often treated with physical therapy. Physical therapy works to increase the stability of the hip joint and the strength of the surrounding muscles, in order to secure the ice cream on the cone and prevent future subluxations. In many cases, four to six months are needed for a complete recovery, and this is only if the correct treatments and physical therapies have been followed.

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