髋关节脱位复位.pdfVIP

Hip Dislocation Reduction 103 Katrina John, Jeffrey Kile, and Amish Aghera 103.1 Indications 103.3 Materials and Medications Displacement of the femoral head in relation to the acetabu- • Parenteral sedation and analgesia medications lum without concomitant femoral neck, head, or acetabulum • Sheet or belt to fi x the pelvis to the stretcher fractures: • Knee immobilizer • Abduction pillow • Posterior hip dislocations make up 80–90 % of cases. • Anterior hip dislocations make up 10–15 % of cases. These are classifi ed into obturator, pubic, iliac, central, or 103.4 Procedure inferior types. Central dislocations are associated with comminuted acetabulum fractures, and inferior disloca- 1. Check the neurovascular status of the affected extremity. tions are a rare occurrence normally occurring in children 2. Obtain anteroposterior (AP) views of the pelvis and lat- younger than 7 years of age. eral views of the hip. • Prosthetic hip dislocations 3. Ensure adequate parenteral sedation and analgesia. 4. Decide upon a technique, as detailed later, and position the patient accordingly. 103.2 Contraindications 5. Once the hip has been successfully reduced, test the joint