Anterior hip dislocation
Introduction
Introduction to anterior dislocation of the hip Simple anterior dislocation of the hip is far less common in posterior dislocation. According to Brav's statistics, it is 14% of posterior dislocation. Aufanc and other statistics are 4% of posterior dislocation. Thompson The statistics are 9% of the post dislocation. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: fracture vascular injury traumatic arthritis
Cause
Causes of anterior hip dislocation
(1) Causes of the disease
When the lower extremities are in excessive abduction and external rotation, the lever can dislocate them.
(two) pathogenesis
There are two main mechanisms of anterior dislocation of the hip. The most common one is excessive abduction and external rotation of the femur. When it reaches a certain level, the large trochanter collides with the upper edge of the acetabulum. Outreach violence or forward violence in the back of the thigh can cause the anterior joint capsule to be torn, and the femoral head dislocation, such as when falling from a height or football to capture football, and secondly, when the femur is abducted and externally rotated, Violence of the lateral side of the thigh can also produce anterior dislocation of the hip joint, even when supine, the strong pressure on the thigh, the femoral head passes through the tibia and pubic capsular ligament of the hip joint (the above-mentioned "" ligament Leverage and forward, causing pre-dislocation, such as mechanical workers under the locomotive locomotive suddenly collapsed and injured both lower limbs, causing anterior dislocation, bilateral anterior dislocation is an unexpected rare type.
Prevention
Prevention of anterior hip dislocation
Avoid trauma.
Complication
Complications of anterior hip dislocation Complications fracture vascular injury traumatic arthritis
1. Fracture: Hip dislocation can be combined with acetabular fracture or femoral head fracture, occasional femoral shaft fracture and hip dislocation occur simultaneously.
2. Vascular injury: The complication of vascular injury is extremely rare. The anterior dislocation of the hip can cause femoral movement and the symptoms of venous compression. At this time, it should be rectified immediately under full anesthesia, avoiding violence during operation.
3. Avascular necrosis of the femoral head: joint capsule tear and round ligament rupture which are unavoidable due to hip dislocation may affect the blood supply of the femoral head. Avascular necrosis occurs in 10% to 20% of cases, about 12 months later. Changes can be seen on the X-ray photographs. It has been confirmed that early reduction can shorten the blood circulation damage of the femoral head. It is the most effective way to prevent femoral head necrosis. The clinical manifestations are persistent inguinal discomfort and hip internal pain, and exercise is limited. Ineffective measures are taken, necrosis continues to deteriorate, and eventually it will lead to severe traumatic arthritis. In severe cases, joint fusion and artificial joint replacement should be performed.
4. Traumatic arthritis: This is a late complication, which is an inevitable result of ischemic necrosis. It can also occur in patients with hip dislocation and articular surface fracture. Generally speaking, patients should avoid it within 2 to 3 years after dislocation. Any excess weight to delay or reduce the occurrence of traumatic arthritis.
Symptom
Symptoms of anterior hip dislocation common symptoms limb shortening deformity in children with hip pain shock swelling at the groin or closed hole
There is a significant history of trauma, the affected limb is abducted, external rotation and flexion deformity, limb shortening, elastic fixation, swelling in the groin or closed hole, and can touch the femoral head, some patients have shock, X-ray examination : The femoral head can be found in the closed hole or near the upper pubis.
Examine
Examination of anterior dislocation of the hip
No relevant laboratory tests.
X-ray examination, the femoral head can be found in the closed hole or near the suprapubic branch to confirm the diagnosis.
Diagnosis
Diagnosis and identification of anterior dislocation of the hip
1. History of trauma caused by strong violence.
2. The affected limb is abducted, externally rotated and flexed deformed. According to the typical malformation, it is not difficult to distinguish between anterior dislocation and posterior dislocation.
3, swelling in the groin, you can touch the femoral head.
4, X-ray film can understand the direction of dislocation. There is currently no relevant information.
Traumatic history, the affected limb was abducted, external rotation and flexion deformity, limb shortening, elastic fixation, femoral head can be touched in the groin or obturator, X-ray film can be diagnosed.
