A 55-year-old woman presents after a high-speed motor...

A 55-year-old woman presents after a high-speed motor vehicle accident. She complains of right hip pain, and on exam you appreciate a shortened, rotated right leg. Which of the following statements is TRUE regarding this patient? (A) If her leg is internally rotated and adducted, she most likely has an anterior hip dislocation. (B) If her leg is externally rotated and abducted, she most likely has a posterior hip dislocation. (C) Closed reduction can wait until radiographs are obtained. (D) Closed reduction should not be attempted unless an orthopedic specialist is available to perform the reduction.

A 55-year-old woman presents after a high-speed motor vehicle accident. She complains of right hip pain, and on exam you appreciate a shortened, rotated right leg. Which of the following statements is TRUE regarding this patient?
(A) If her leg is internally rotated and adducted, she most likely has an anterior hip dislocation.
(B) If her leg is externally rotated and abducted, she most likely has a posterior hip dislocation.
(C) Closed reduction can wait until radiographs are obtained.
(D) Closed reduction should not be attempted unless an orthopedic specialist is available to perform the reduction.

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Key Concepts

Hip Dislocation Classification

Hip dislocations are categorized as either posterior or anterior, with distinguishing clinical features and mechanisms. Posterior hip dislocations, which are the most common, typically present with a shortened, adducted, and internally rotated limb following trauma, whereas anterior dislocations often manifest with an externally rotated and abducted leg.

Closed Reduction in Hip Dislocation

The management of hip dislocations typically involves an urgent closed reduction to minimize the risk of complications like avascular necrosis. Although timely reduction is critical, clinicians must first obtain appropriate imaging studies to rule out associated fractures or other contraindications. This imaging does not unduly delay reduction if performed expeditiously.

Radiographic Evaluation Prior to Reduction

Radiographs play a crucial role in the evaluation of suspected hip dislocation, as they confirm the diagnosis and help to identify concomitant injuries. While reduction is time-sensitive, standard practice is to quickly acquire radiographs to ensure safe management rather than attempting reduction without the required diagnostic information.

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