The structure of the hip joint allows it to move freely. At the moment when the displacement of the acetabulum of the head of the joint occurs, an injury is formed. Dislocation of the hip joint in adults most often occurs due to the influence of great force and impact. But the symptoms of pathology and treatment methods are described below.
Reasons
This problem is quite rare, as it occurs in only 5% of traumatized individuals. The main causes of the problem are:
- natural disasters;
- car accidents;
- sport;
- falling from great heights.
Another cause of hip dislocation in adults is an improperly fitted prosthesis. Similar complications are observed in 5% of those operated on in the first month of rehabilitation. Pathology occurs due to the following factors:
- lack of surgeon skill;
- wrong choicesize of parts of the prosthesis;
- non-compliance by the operated patient with the rules of rehabilitation.
Symptoms
Treatment of dislocation of the hip joint in adults and diagnosis begins with the appearance of characteristic signs of pathology. All of them differ depending on the type of injury, although they mostly have common manifestations. The main symptoms are:
- unbearable pain in the leg;
- unnatural foot placement;
- forced posture;
- edema;
- joint deformity;
- limited movement;
- bleeding in the buttocks or groin;
- not being able to step on the foot,
In case of incomplete dislocation, the patient may not feel the injury and continue to move. Further, at the time of the load, the pain will manifest itself. For any of the above symptoms, you should consult a doctor. In case of severe damage, it is better to call doctors to the victim.
Classification of dislocations
Injury can be classified into four types for further diagnosis and treatment.
- One of the most common is the posterior dislocation. The head of the joint moves to the back of the body, while it can go both up and down. Most often, such symptoms of a dislocation of the hip joint in adults after accidents occur, in the case when, during sudden braking, the human body moves forward at the time of the collision. The victim feels unbearable pain, and there is also swelling of the thigh. Such damage can lead to seriousconsequences. The sciatic nerve is located close to this site. At the time of injury, it is often pinched or damaged. Insufficient blood circulation can result in tissue necrosis. At the time of diagnosis, an x-ray is performed to determine the degree of damage and determine the tactics of treatment.
- In the case of an anterior dislocation, the head is displaced forward so much that it can even be felt in the groin. The main symptoms of hip dislocation in adults of this type is a condition in which a person cannot step on the foot, it swells and hurts very much, sometimes foot numbness occurs. The diseased limb will apparently become longer.
- Central dislocation or fracture is considered the most difficult at the time of treatment. A photo of the symptoms of a dislocation of the hip joint in adults can be considered further. At the time of injury, crushing of the acetabulum occurs. Unbearable pain is felt, and there is no way to move your leg. After such a pathology, an immediate operation is performed. The treatment is quite long, the recovery period is long, with further development of the limb.
Subluxation is an injury when there is an incomplete exit of the head from the acetabulum, and is only partially displaced. Signs of pathology appear immediately, the person begins to limp, and pain is observed in the thigh. The length of the limbs can also be different. With such an injury, the treatment consists in establishing the head in its original place. If the patient does not know how to correct the dislocationhip joint in adults, then in this case it is imperative to consult a doctor. In the case where there is no fracture, surgery can be dispensed with
Congenital pathology
Congenital dislocation of the hip joint in adults occurs due to a violation of the normal development and functioning of the hip joint. According to studies, this problem occurs in 1 in 7,000 newborns. Pathology occurs in girls 6 times more often than in boys. A unilateral lesion appears more often 2 times than a bilateral one.
Since the consequences of hip dislocation in adults are very serious, modern medicine has accumulated vast experience in the treatment and diagnosis of such a problem. Research data have shown that if left untreated, trauma can lead to early disability. The sooner you start therapy, the better the final result will be, so at the slightest suspicion of hip dislocation, you need to show the baby to an orthopedist.
If you do not attach importance and do not treat the problem at an early age, it can provoke dysplastic coxarthrosis at the age of 25-30 years, which is accompanied by limited mobility and pain in the joint, which gradually lead to the patient's disability.
If left untreated, joint pain and lameness begin to appear between the ages of 3-5.
Diagnosis
Identifying an injury is quite simple, as you can visually contemplate its signs. In each case, the malposition of the limb is noticeable. Also in the femoral part, most likely, there will be large hematomas. With passive movements, a sharp pain is formed, which also confirms the diagnosis. An x-ray is used to determine the type of dislocation. The picture is taken in frontal and lateral projections. Injuries are classified according to the location of the femoral head. In case of disputes, they resort to MRI studies (magnetic resonance imaging). The picture will show cracks, chips and other irregularities.
Diagnosing chronic injuries can be problematic. This is due to the fact that over time the pain subsides, and the shortened limb is compensated by tilting the torso and curvature of the spine in the problematic direction. As a result, a change in gait is provoked and lameness becomes noticeable. For diagnosis, specialists use a qualitative study of the image.
First Aid
Symptoms of dislocation of the hip joint in adults are very vivid and characteristic. Therefore, many may suspect the presence of this problem.
- The first thing to do is to call an ambulance. Before her arrival, it is not advised to move the victim.
- Self-performed such actions that will help to immobilize the limb. To do this, a splint is installed, starting from the armpit to the end of the ankle joint.
- It is also recommended to keep the person warm and drink plenty of water.
- An injection with an anesthetic is given to prevent pain shock.
Transportation to the hospital is performed lying onhard surface.
Treatment
When a dislocation of the hip joint in adults is diagnosed, a photo of which can be seen below, then qualified treatment is prescribed. Since with timely medical intervention, serious consequences can be avoided.
Therapy consists of certain steps:
- dislocation reduction;
- fixing with plaster;
- recovery and rehabilitation period.
The most commonly used is one of the well-known reduction methods.
1. The method of "Dzhanelidze" - is used in many cases in the diagnosis of oblique dislocation. The main steps of the procedure are as follows:
- the patient is placed on the table, while his face rushes down;
- the injured limb should hang down;
- for 10-15 minutes she takes a right angle relative to the body;
- next, the trauma surgeon performs point movements in the femoral and knee joints, thanks to such manipulations, the head is redirected to the acetabulum, and an unpleasant click will be heard;
- if everything is done correctly, then the patient will be able to inertly move the limb.
2. If in the treatment of dislocation of the hip joint in adults the first option did not give positive results, then the Kocher-Kafer method is used. The patient is also in a horizontal position, but only face up. When the pelvis is fixed, the surgeon holds the damagedlimb and begins to carry out several rough movements, as a result of which the problem joint returns to its original place. Then the patient is required to undergo skeletal traction.
There are some nuances in the treatment of subluxation. Pathology occurs due to incomplete displacement of the head in relation to the acetabulum. In adults, this pathology is almost impossible to cure.
The main goal of therapy is to restore the normal position of the joint. Painkillers may be prescribed.
If there is a need, then a specialist can prescribe surgical intervention:
- palliative surgery;
- osteotomy;
- reposition open type.
After the treatment of hip dislocation in adults, the recovery phase takes about 6 months. If you do not give the load in time, then the formation of bone tissue necrosis is possible due to problems with blood circulation.
Expeditious implementation
Such an intervention may be needed after ineffective conservative therapy or chronic dislocation.
1. Open reduction may be needed when there is debris and damage to nerve fibers and muscles. In this case, therapy includes:
- cutting the skin to gain access to the joint;
- removal of tissues located between the pelvis and the head of the femur;
- stapling the ligaments, and then inserting the hip.
2. When the function of the joint is lost, thenit is required to perform arthrodesis - fixing the affected joint. Sometimes there is a need to replace the affected part with a prosthesis. The introduction of artificial parts is called arthroplasty. The selection of the prosthesis is carried out depending on the weight and age of the patient.
Dislocation of the hip joint in adults after arthroplasty
The symptoms of this problem are very similar to the classic variants, so it is very easy to recognize them. It should be noted that dislocation of the endoprosthesis is a rather rare occurrence, and the problem is observed in 5% of those operated on. Experts identify three main factors contributing to the unstable position of the joint. The following factors are cited as the main reasons:
- Surgical implementation - very often the hip begins to lose its stability after the wrong choice of the location of the prosthesis, as well as the incision of soft tissues. For example, specialists practice posterior access, as it speeds up the rehabilitation process. Although in this case, the muscle tissue does not suffer at all, but this increases the possibility of dislocation.
- Professionalism of the surgeon – there are many cases when such complications were caused by the installation of an endoprosthesis without correct balancing of the artificial joint. Proper placement of an artificial joint requires many factors to be taken into account, including the medical condition that requires the replacement.
- Quality of the selected prosthesis.
The usual reduction by any of the above methods is most often enough to achieve a stableremission, thereby eliminating the risk of negative complications. Sometimes, due to such a problem, there is a need to re-install the endoprosthesis.
Consequences of dislocation
The most important and unpleasant complication in the treatment of dislocation of the hip joint in adults at home is the rupture of the joint capsule, which quite often leads to irreversible consequences occurring in the head of the femur. In the future, if appropriate treatment is not performed, this can create favorable conditions for the formation of coxarthrosis, as well as negatively affect soft tissues.
It should be noted that only subluxation does not lead to major complications, since there is no rupture of the joint capsule.
If the disease is not treated, it may affect later life, since even the smallest and slightest movement will cause the patient to experience acute pain.
But if the symptoms of dislocation of the hip joint in adults are recognized in time and timely treatment is prescribed, this may allow the patient to return to his usual working capacity. A lot in recovery and getting complications wins back the professionalism and skills of the attending physician, as well as the moment at which the patient asked for help, because the sooner therapy is started, the less negative consequences will be in the future.
Rehab
At the moment of recovery, all efforts are directed to restore the stability of the joint and its full mobility. This problem is most often solved using complex manual and medical therapy. Also, these activities are necessarily supplemented by special exercises. It is important to know that it is possible to treat dislocation of the hip joint in adults without fever at home, if it is elevated, it means that there is an inflammatory process in which it is necessary to consult a doctor. For effective therapy, the following activities are performed:
- LFK (therapeutic physical culture) exercises - at the time of drawing up the training program, the complexity of the injury must be taken into account. In the case of a bilateral lesion, exercises with passive movements are included in the program. After improvement is noticeable, it is allowed to strain the limb with more force.
- Massage - this procedure is useful because it helps to restore the motor ability of muscle tissue. Each of these injuries negatively affects the condition of the fibers, and as a result, a strong spasm is formed. The massage therapist needs to relax the muscular system to the maximum and remove the contracture. Just for this, such manipulation is used.
Different methods of rehabilitation after a dislocation should last quite a long time, at least 2-3 months, it all depends on the severity of the injury. During this period, the patient should try to minimize the various movements of the joint, which has a pathology. Over time, the condition of the joint will begin to improve, so you can gradually increase the load and in the end bring it back to the usual.
After the dislocation is importantreceive qualified treatment, therefore, before contacting a doctor, it is imperative to inquire about the doctor's practice, since it is this condition that will help prevent the formation of complications in the future, as well as the occurrence of chronic tissue disorders.
