Dislocation > Treatments
First Aid and Ambulance Care
Hip dislocations require immediate treatment. Physicians
generally suggest an ambulance be called to transport
someone with a dislocated hip to the hospital's
emergency room. Physicians generally suggest an ambulance
be called to transport someone with a dislocated hip
to the hospital's emergency room. Often there
are associated injuries that require transport by Emergency
services to the hospital for an evaluation by a trauma
team. If you or someone you know dislocates a hip, the
following first aid tips can help you better understand
what to do:
call for an ambulance.
not attempt to move the injured hip or the injured person
unless someone is present who knows how to properly
immobilize the hip.
the injured person still and calm, lying flat on his
back. Cover the injured person with a blanket if available.
dislocations may cause open wounds. Cover the wound
with a sterile dressing if available and wait for the
paramedics to arrive.
possible, do not let injured people eat or drink. They
may be going under anesthesia soon. The paramedics can
give someone an IV if they need fluids, so avoid giving
the injured person anything by mouth.
Paramedics will most likely immobilize your hip and
place you securely onto a gurney in the back of the
ambulance. If possible, it is a good idea to have someone
accompany you to the hospital to assist you. Most dislocated
hips feel as though they desperately need to be popped
back into place. However, paramedics generally do not
treat you before arrival at the emergency room because
there could be complications that should be treated
in the hospital. Remember that a dislocated hip can
cause a variety of damage to tissues, which requires
a proper diagnosis in the emergency room before most
dislocations can be reset.
A non-operative, or closed, reduction
to correct a hip dislocation is performed without surgical
instruments or incisions. Depending on the direction
of your hip dislocation, you will lie on your back or
stomach after you are given pain medications. Under
anesthesia consisting of further pain medications, muscle
relaxants, and sedatives, your physician and an assistant
will stabilize your pelvis, flex or extend your hip
and knee, apply traction to your lower extremity, and
gently rotate your thigh internally or externally, to
gently move the femoral head back into its original
location within the acetabulum. While you are still
under anesthesia, your surgeon and an assistant will
also move your hip to assess its stability after reduction.
The procedure usually takes less than a half-hour and
is performed in either the emergency room or the operating
room depending on the resources available to administer
anesthesia. After the closed reduction attempt, a repeat
x-ray is obtained to check to see if the hip is completely
reduced, and to see if there are any fractures around
the hip or loose bone fragments in the hip joint. In
most cases, a CT scan will also be obtained to look
for the presence of bone fragments within the joint,
to make sure that the hip is completely reduced, and
to look for and characterize possible fractures. If
the closed reduction attempt is unsuccessful, another
attempt under deeper anesthesia may be required. If
this proves unsuccessful or there is an associated fracture,
an open reduction, in which the surgeon makes an incision
and directly exposes the hip to reduce the dislocation
and fix any fractures, may be required. After successful
reduction of a simple hip dislocation, you usually will
experience marked pain relief. However, there usually
is some mild residual pain that can be controlled with
oral pain medications.
After a successful closed reduction
of a hip dislocation, you will usually stay in the emergency
room or recovery room for at least two hours while the
anesthetic wears off. Associated injuries may dictate
a hospital stay and operative intervention. You may
have a foam pillow between your legs to keep your legs
spread apart and your hips in a more stable position.
You still should try to move your feet, ankles, and
knees while you are in the recovery room and at home
to improve circulation. Your temperature, blood pressure,
and heartbeat will be monitored by a nurse, who, with
the assistance of the anesthesiologist, will determine
when you are ready to leave the hospital or, if necessary,
be admitted to the hospital. You may require admission
to the hospital for pain control. If your hip was unstable
during range of motion, you may require temporary bracing,
casting, or a surgical procedure to prevent your hip
from redislocating. You may require the assistance of
a walker or crutches to aid you with ambulation. Your
surgeon will review your discharge and follow-up instructions
with you before you go home.
Here is what you can expect and how
you can cope while recovering at home from an non-operative
closed reduction of your dislocated hip:
some pain for the first week or so. If needed, take
oral pain medications as instructed by your physician.
The pain tends to decrease each day. Call your physician
if you experience unexpected pain.
and modify your activities, but do not remain at bed
rest, as inactivity results in deconditioning and may
contribute to the development of blood clots.
physician may prescribe a V-shaped pillow to be worn
between your legs that keeps your legs spread apart
and your hip in a more stable position.
your hip is stable, then no bracing or casting is necessary.
If it is unstable in certain positions, then you may
be fitted with a brace or cast that prevents these positions.
Usually, the brace or cast is worn for 6-8 weeks. The
cast is usually made of fiberglass.
balanced diet, vitamin supplements, proper hydration,
and exercise may help you recuperate and get you back
on your feet again.
may find it difficult to move around your house and
perform even simple household tasks like cooking, bathing,
and laundry. You should arrange for someone to be available
to visit you once or twice a day for several weeks.
If you live alone, the hospital can refer a social worker
or nurse to assist you at home.
to begin range of motion and walking exercises as soon
as possible as instructed by your physician. Your physician
will likely refer you to a physical therapist to begin
supervised strengthening and stretching exercises within
a week of non-operative reduction.
to call the doctor after surgery
Though everyone's rehabilitation
program is slightly different, physical therapy follows
a general pattern. Regaining range of motion is crucial.
Movement may be painful at first, but it is important
to avoid stiffening in of your hip. However, you do
not want to go beyond the prescribed ranges of motion
for your hip and risk a repeat dislocation. For the
first few weeks, your physical therapist may help you
move your hip in different directions to preserve joint
motion and strength. As time progresses and more healing
occurs, your physician will gradually increase the allowed
range of motion of the hip. By 10 to 12 weeks, you should
be up to unrestricted range of motion of the hip. If
you have had a simple hip dislocation without a fracture,
then you are usually allowed to bear weight as tolerated
on the affected lower extremity with a walker or crutches
as needed. If you have sustained a hip fracture, then
the amount of weight that you will be allowed to bear
will be limited by your physician. Physical therapy
also seeks to keep the muscles around your hip strong.
It can take a minimum of six weeks for any soft–tissue
damage around the hip joint to heal. Patients should
eventually be able to resume previous functional activities
like stair climbing, single leg support, swimming, and
driving. You may be able to begin more vigorous activities
as your hip heals and gets stronger. This usually takes
about three months. Your physician will monitor your
recovery by physical examination and appropriate diagnostic
testing including X-rays, CT scans and MRI (magnetic
Once your dislocated hip has healed,
rebuilding and maintaining muscle strength around your
hip can help you return to your previous level of function
and avoid further injuries. If necessary, you may also
consider training with a physical therapist to improve
your balance and coordination, which can help decrease
the chances of falls. Since most hip dislocations are
the result of accidental trauma, early evaluation and
treatment should be stressed to prevent complications.
If you experience a recurrence of hip pain, your physician
should be contacted and weight bearing should be avoided
until it you are evaluated. Contact sports and activities
increase your chances of re–injuring your hip.
Your physician may advise you to avoid contact sports
and high–impact activities like downhill skiing.
Another way to help prevent further hip injuries is
to learn to avoid activities that put your hip in potentially
unstable positions. After a hip dislocation, take it
easy until you have regained hip stability and strength.
If your physician believes that post–traumatic
arthritis might be a major issue, avoid high–impact
activities and activities that cause you pain. Remember,
there is no substitute for conditioning. It is essential
to adhere to the hip muscle strengthening program you
learned during rehabilitation throughout the remainder
of your life. The best strengthening programs focus
on low–impact and non–weight–bearing,
like stationary bikes, swimming, and certain weightlifting
programs. Your physician will usually schedule an MRI
to make sure you have not developed avascular necrosis
before clearing you to return to sports or activities.