Posterior Hip Dislocation

In the United States, hip dislocations are responsible for significant morbidity and potentially mortality with deleterious consequences to the surrounding anatomy, neighboring joints, and an individual's functional ability.In the evaluation of posterior hip (femur) dislocation, the first question an examiner should answer is whether the patient has a native hip or a prosthetic hip joint, as the clinical approach varies significantly. Additionally, it is paramount to evaluate for associated injuries such as fractures, as this will also drastically alter management.The native hip joint is inherently stable and requires a significant amount of force to cause dislocation; as such, hip dislocation in native joints are often secondary to traumatic events such as motor vehicle accidents. Due to the traumatic nature and force required to dislocate a native hip joint, it is not surprising that 95% of patients who present with a hip dislocation after a motor vehicle collision had an associated injury requiring inpatient management. Thus, with native hip dislocation, a detailed neurologic and musculoskeletal examination with additional x-ray or CT scans for assessment is mandatory. Conversely, prosthetic or non-native hip dislocations are a relatively common occurrence to emergency departments nationwide as the inherent stability of the joint is less than that of a native joint. Prosthetic joint dislocations are most often associated with minor mechanisms and require a more reserved approach.