The structure of the hip joint allows it to move freely. At the moment when there is a displacement from the acetabulum of the head of the joint, an injury is formed. Dislocation of the hip joint in adults most often occurs due to the influence of great strength and shock. But the symptoms of pathology and treatment methods are described below.
Causes
This problem is quite rare, as it occurs only in 5% of injured individuals. The main causes of the problem are:
- natural disasters;
- car crashes;
- sport;
- falling from a great height.
Another cause of dislocation of the hip joint in adults is an improperly installed prosthesis. Similar complications are observed in 5% of those operated on in the first month of rehabilitation. Pathology occurs due to the following factors:
- insufficient skill of the surgeon;
- wrong size of the prosthesis parts;
- non-compliance by the patient with the rules of rehabilitation.
Symptoms
Treatment of hip dislocation in adults and diagnosis begin with the appearance of characteristic signs of pathology. They all differ depending on the type of injury, although they generally have common manifestations. The main symptoms are:
- unbearable pain in the leg;
- unnatural position of the leg;
- forced posture;
- edema;
- joint deformation;
- limited movement;
- hemorrhage in the buttocks or groin;
- the inability to step on the foot
In case of incomplete dislocation, the patient may not feel injuries and continue to move. Further, at the time of loading, the pain will manifest itself. For any of the listed symptoms, you must consult a doctor. In case of severe damage, it is better to call the doctor to the victim.
Classification of dislocations
Injury can be divided into four types, according to which further diagnosis and treatment are carried out.
- One of the most common is posterior dislocation. The head of the joint moves to the back of the body, while it can go both up and down. Most often there are such symptoms of dislocation of the hip joint in adults after accidents, in the case when, under sharp braking, the human body is moved forward at the time of the collision. The victim feels unbearable pain, and there is also hip edema. Such damage can lead to serious consequences. The sciatic nerve is close to this site. At the time of injury, it often gets pinched or damaged. Inadequate blood circulation can result in tissue necrosis. At the time of diagnosis, an x-ray is performed to identify the degree of damage and determine treatment tactics.
- In the case of a front dislocation, the head shifts forward very strongly, which can even be felt in the groin. The main symptoms of dislocation of the hip joint in adults of this type is a condition in which a person cannot step on his leg, it is very swollen and painful, sometimes numbness of the foot is found. The diseased limb will probably become longer.
- A central dislocation or fracture is considered the most difficult at the time of treatment. A photo of the symptoms of a hip dislocation in adults can be considered further. At the time of damage, the acetabulum is crushed . Unbearable pain is felt, and there is no possibility to move a foot. After such a pathology, an immediate operation is performed. The treatment is quite long, the recovery period takes a long time, with the further development of the limb.
- A subluxation is damage when an incomplete exit of the head from the acetabulum is observed, and only partially displaced. Signs of pathology appear immediately, the person begins to limp, and pain is observed in the thigh. The length of the limbs can also be different. With such an injury, the treatment is to establish the head in its original place. If the patient does not know how to correct the dislocation of the hip joint in adults, then in this case you should definitely consult a doctor. In the case when there is no fracture, you can do without surgery.
Congenital pathology
Congenital dislocation of the hip joint in adults occurs due to impaired normal development and functioning of the hip joint. According to studies, this problem occurs in 1 out of 7,000 newborns. Pathology occurs in girls 6 times more often than in boys. Unilateral lesion appears more often 2 times than bilateral.
Since the consequences of dislocation of the hip joint in adults are very serious, modern medicine has accumulated vast experience in the treatment and diagnosis of such a problem. Research data has shown that if untreated, it can lead to early disability. The sooner you start therapy, the better the final result will be, therefore, with the slightest suspicion of hip dislocation, you need to show the baby an orthopedic surgeon.
If you do not attach importance and do not treat the problem at an early age, then this can provoke dysplastic coxarthrosis at the age of 25-30 years, which is accompanied by limited mobility and joint pain, which gradually leads to disability of the patient.
If you do not conduct therapy, then joint pain and lameness begin to appear at the age of 3-5 years.
Diagnostics
It is quite simple to identify an injury, as you can visually contemplate its symptoms. In each case, the incorrect position of the limb is noticeable. Also in the femoral part are likely to be large hematomas. With passive movements, a sharp pain forms, which also confirms the diagnosis. To establish the type of dislocation, X-rays are used. The picture is taken in front and side projections. Damage is classified by the location of the femoral head. In the event of a controversial situation, they resort to MRI studies (magnetic resonance imaging). The picture will show cracks, chips and other irregularities.
Diagnosing chronic injuries can cause problems. This is due to the fact that over time the pain subsides, and a shortened limb is compensated by tilting the body and curving the spine to the problem side. As a result, a change in gait is provoked and lameness becomes noticeable. For diagnosis, specialists use a qualitative study of the image.
First aid
Symptoms of hip dislocation in adults are very bright and characteristic. Therefore, many may suspect the presence of this problem.
- The first thing to do is to invite an ambulance crew. Prior to her arrival, it is not advisable to relocate the victim.
- Independently performed such actions that will help immobilize the limb. For this, a span is installed, starting from the armpit to the end of the ankle joint.
- It is also recommended to provide a person with warmth and plenty of drink.
- To prevent pain shock, an injection with an anesthetic is done.
Transportation to the hospital is carried out lying on a hard surface.
Treatment
When a dislocation of the hip joint in adults is diagnosed, a photo of which can be seen later, then qualified treatment is prescribed. Since with timely medical intervention, serious consequences can be avoided.
Therapy consists of certain stages:
- reduction of dislocation;
- gypsum fixation;
- recovery and rehabilitation period.
Most often, one of the known reduction methods is used.
1. The "Janelidze" method - is used in many cases when diagnosing an oblique dislocation. The main steps in the procedure are the following:
- the patient is placed on the table, and his face rushes down;
- the injured limb should hang down;
- for 10-15 minutes it takes a right angle relative to the body;
- further, the trauma surgeon performs point movements in the femoral and knee joints, thanks to such manipulations, the head is redirected to the acetabulum, and an unpleasant click is heard;
- if everything is done correctly, then the patient will have the opportunity to inertly move his limb.
2. If the first option did not give positive results in the treatment of dislocation of the hip joint in adults, then the Kocher-Kafer method is used. The patient is also located in a horizontal position, but only face up. When the pelvis is fixed, the surgeon holds a damaged limb in his hand and begins to make several rough movements, as a result of which the problematic joint returns to its original place. Then, the patient is given a skeletal traction without fail.
In the treatment of subluxation has its own nuances. Pathology occurs due to incomplete displacement of the head relative to the acetabulum. In adults, this pathology is almost impossible to cure.
The main objective of therapy is to restore the normal location of the joint. Perhaps the appointment of painkillers.
If there is a need, then a specialist may prescribe a surgical intervention:
- palliative surgery;
- osteotomy
- reduction of open type.
After treatment of dislocation of the hip joint in adults, the recovery phase takes about 6 months. If the load is not given in time, then formation of bone necrosis is possible due to problems with blood circulation.
Operational implementation
Such an intervention may be needed after ineffective conservative therapy or a chronic dislocation.
1. Open reduction may be needed when there are debris, as well as damage to nerve fibers and muscles. In this case, therapy involves:
- skin dissection to gain access to the joint;
- removal of tissue between the pelvis and femoral head;
- stitching ligaments, and after inserting the thigh.
2. When the function of the joint is lost, it is necessary to perform arthrodesis - fastening the affected joint. Sometimes there is a need to replace the affected part with a prosthesis. The introduction of artificial parts is called endoprosthetics. The selection of the prosthesis is carried out depending on the weight and age of the patient.
Hip dislocation in adults after endoprosthetics
Symptoms of this problem are very similar to the classic options, so it is very easy to recognize them. It should be noted that dislocation of the endoprosthesis is quite rare, and the problem is observed in 5% of operated. Specialists distinguish three main factors contributing to the unstable position of the joint. The main reasons are the following factors:
- Surgical implantation - very often the hip begins to lose its stability after improper selection of the prosthesis placement method, as well as in the incision of soft tissues. For example, specialists practice rear access, since with its help the rehabilitation process is accelerated. Although in this case muscle tissue does not suffer at all, but this increases the possibility of dislocation.
- Professional surgeon - there are many cases where the installation of an endoprosthesis without proper balancing of an artificial joint led to such complications. For the correct selection of the location of the artificial joint, many factors must be taken into account, including the disease, which requires prosthetics.
- The quality of the selected prosthesis.
The usual reduction by any of the above methods is often enough to achieve a stable remission, thereby eliminating the risk of negative complications. Sometimes, due to such a problem, the need arises to reinstall the implant.
The consequences of a dislocation
The most important and unpleasant complication in treating home dislocation of the hip joint in adults is rupture of the joint capsule, which often leads to irreversible consequences that occur in the femoral head. In the future, if the appropriate treatment is not performed, this can create favorable conditions for the formation of coxarthrosis, as well as adversely affect the soft tissues.
It should be noted that only subluxation does not lead to serious complications, since there is no rupture of the joint capsule.
If the disease is not treated, this can affect later life, since when the patient makes even the smallest and slightest movement, he will experience acute pain.
But if you recognize the symptoms of hip dislocation in adults in time and prescribe timely treatment, then this can allow the patient to return to his usual working capacity. The professionalism and skills of the attending physician play a lot in recovering and getting complications, as well as the moment at which the patient asked for help, because the sooner you start therapy, the less negative consequences will be in the future.
Rehabilitation
At the time of recovery, all efforts are aimed at restoring the stability of the joint and its full mobility. This problem is most often solved using complex manual and medical therapy. Still these actions are without fail supplemented by special exercises. It is important to know that it is possible to conduct at home treatment of dislocation of the hip joint in adults without temperature, if it is elevated, then there is an inflammatory process in which it is necessary to consult a doctor. For effective therapy, the following activities are performed:
- Exercise therapy (therapeutic physical culture) exercises - at the time of drawing up the training program, the complexity of the injury is necessarily taken into account. In the case of a bilateral lesion, exercises with passive movements are included in the program. After improvements become noticeable, it is allowed to strain the limb with greater force.
- Massage - this procedure is useful in that it helps to restore the motor ability of muscle tissue. Each of these injuries negatively affects the condition of the fibers, and as a result of this, a strong spasm is formed. The masseur needs to relax the muscle system and remove contracture. Just for this, a similar manipulation is used.
Various methods of rehabilitation after a dislocation should last quite a long time for at least 2-3 months, it all depends on the strength of the injury. For this period, the patient should try to minimize various movements of the joint, which has a pathology. Over time, the condition of the joint will begin to improve, so you can gradually increase the load and in the end bring them to the usual.
After a dislocation, it is important to get qualified treatment, so before you go to the doctor, you should definitely ask the doctor about the practice, since this condition will help to prevent the formation of complications, as well as the occurrence of chronic tissue disorders.