Symptoms of a Dislocated Hip

A hip dislocation is one of several types of dislocations. A hip dislocation occurs when the ball joint (known as a “synovial joint”) in the hip comes out of the socket. The synovial joint can either be pushed out anteriorly or posteriorly and is commonly caused by traumatic injury to the hip. In some cases, however, it is possible to be born with structural problems in the hip that may not manifest until later in life through a condition called “hip dysplasia,” otherwise known as developmental dislocation of the hip (or DDH). 

When a hip becomes dislocated, it may feel as if it gives out suddenly, followed by sharp pain. Experiencing a dislocated hip should be treated as a medical emergency as it can lead to more serious health complications if left untreated.

Understanding the Hip

The hip joint is a ball-and-socket joint that is composed of many components, including:

• Tendons
• Cartilage
• Ligaments
• Muscle
• Bone
• Synovium
• Bursa

The hip contains the epiphysis (or end) of the thigh bone (known as the “femur”) that fits into a socket of the hip (known as the “acetabulum”). The hip is responsible for many functions such as holding body weight, movement of the upper leg, and balance.

Types of Dislocations

It is possible for the hip to become dislocated either posteriorly (pushed back) or anteriorly (pushed forward). After either type of dislocation, the hip will look shortened and turned on one side. 

Posterior: Posterior dislocations of the hip are the most common type that can occur. In a posterior dislocation, the lower limb is flexed, adducted (i.e., moved towards the body’s midline) and internally rotated. 

Anterior: In an anterior hip dislocation, the limb will be extended, abducted (i.e., moved away from the body’s midline) and externally rotated.

Partial vs. Full Dislocation

It is also possible to have a full hip dislocation or a partial hip dislocation, which is also known as “hip subluxation.” If you have a partial hip dislocation you will experience similar symptoms as a full dislocation, although the pain may not be as severe. You may be able to continue walking and bearing weight on the joint.

Causes

There are three main causes of hip dislocation. Injury is the most common cause of a dislocated hip which can result from incidents such as a car crash, sports accident, or fall. 

Recognizing the Symptoms of a Dislocated Hip

Recognizing the symptoms of a dislocated hip is crucial for timely intervention and treatment. The most common symptoms include severe pain, inability to move the leg, and a visible deformity of the hip or leg.

The pain is typically immediate and intense, and is often described as excruciating. This pain is usually concentrated in the hip area but can also radiate to the groin, buttock, or knee.

In addition to these symptoms, patients may experience:

• Swelling or bruising around the hip area
• Numbness or tingling in the leg or foot
• Difficulty walking or bearing weight on the affected leg

Can You See a Dislocated Hip Without an X-ray?

In many cases, patients may be able to see a dislocated hip visually. Very often, the leg on the dislocated side may look shorter than the unaffected leg. There can also be bruising and swelling around the dislocation site. Additionally, if the dislocation is pushed forward out of the socket (anteriorly), the knee and foot may then point outward. If the dislocation is pushed backward out of the socket (posteriorly), then the knee and foot may point inward.

Severe Pain and Immobility

The pain associated with a dislocated hip is often severe and immediate. It can make it difficult or impossible for the patient to move the affected leg.

This immobility is a direct result of the displacement of the femur from the hip socket, which disrupts the normal function of the joint.

Neurovascular Compromise Indicators

In certain cases, a dislocated hip can affect the nerves and blood vessels around the hip joint. This may lead to numbness, tingling, or a feeling of coolness in the leg or foot.

These symptoms might indicate a neurovascular compromise, which requires immediate medical attention to prevent permanent damage.

What Other Problems Could Result?

If a dislocation is not treated immediately, there is the possibility of further damage to the injured hip and surrounding nerves and tissue. For example, the longer the dislocation goes untreated, the more likely a patient will experience a sciatic nerve injury, which worsens the existing injury.

Additionally, the longer that a hip remains untreated, the more unstable it will become which can lead to an increased chance of injury.

How is a Dislocation Diagnosed?

Hip dislocations are diagnosed using a combination of X-rays, CT scans, and MRI to determine their type and extent of the damage. A CT scan can clearly outline any bone damage that may have occurred during the dislocation, especially if caused by injury or trauma to the area. For example, marginal impaction can create compression or indentation on the bone surface. Another possibility is a displaced wall fracture, which may lead to arthritis.

Treatment Options

Many patients may be relieved to learn that surgery is often not needed for a hip displacement, providing the joint can be pushed back into place by hand. 

Non-Surgical Treatment

Before surgery is performed, the doctor will attempt to push the hip joint back into its socket through a process called “closed reduction.” Pain medication is administered, and – in special cases – anesthesia may be necessary. If the doctor is able to place the femoral head back into place using closed reduction, then no large cuts or surgery would be needed. 

Surgical

When surgery is necessary, the procedure is called “open reduction.” If there is still instability in the hip joint upon completion of a closed reduction procedure – or if there is any fracturing in the hip – surgery may then be necessary. 

Recovery from Hip Displacement

Recovery from hip displacement is a process that requires time, patience, and commitment. The recovery timeline can vary greatly depending on the severity of the dislocation and the individual’s overall health.

Physical therapy plays a crucial role in this recovery process, as it helps restore strength, flexibility, and mobility to the hip joint, thus facilitating a return to normal activities.

Pain management is another key aspect of recovery. This often involves a combination of medication, physical therapy techniques, and lifestyle modifications.

Physical Therapy and Rehabilitation

Physical therapy for a dislocated hip typically begins with gentle exercises to improve range of motion. As the hip heals, the intensity of the exercises gradually increases to strengthen the muscles supporting the hip joint.

Rehabilitation also includes balance and gait training. These exercises help improve stability and prevent falls, which could lead to further injury.

The use of assistive devices – such as crutches or walkers – may be recommended during the initial stages of recovery. These devices provide support and help maintain mobility while the hip heals.

It’s important to note that each rehabilitation program is tailored to the individual’s particular needs and progress. Regular follow-ups with the assigned physical therapist are crucial to monitor progress and adjust the program as necessary.

Long-Term Recovery and Prevention

Long-term recovery from a hip displacement involves maintaining hip health and preventing future dislocations. This includes regular physical activity to keep the hip joint strong and flexible. Exercises that include knee lifts, leg raises, and hip circles can help to build stability in the hip. 

Preventative measures also involve learning and practicing proper techniques during physical activities – especially sports – to avoid injuries. Regular check-ups with a healthcare provider are also essential to monitor the hip joint and address any potential issues early.

Contact MSJ

If you think you have dislocated your hip, it is important to seek medical attention quickly to avoid further injury. If you are a new patient to Monterey Spine & Joint, you can call, text us, or view our contact information online.