Patient came into emergency department with flexion, adduction and internal rotation of hip. Diagnosis?
Ans. (b) Posterior dislocation of hipRef: Maheshwari 5th ed. /130POSTERIOR DISLOCATION OF HIP* It is most common type of hip dislocation in adults and children.* Usually this occurs in a road accident when someone seated in car is thrown forwards, striking the knee against the dashboard (dashboard injury)* It is the position (direction) of hip at the time of injury that decides the pattern of injury.Pattern of injuryPosition of Hip at the time of InjuryPure posterior dislocationFlexion, adduction, internal rotationPosterior fracture dislocationLess flexion, less adduction (neutral or slight abduction), internal rotationAnterior dislocationHyper abduction + ExtensionClassification Schemes for Posterior Hip DislocationsThompson & EpsteinType 1Dislocations without or with minor fractureType IIDislocation with a single large fracture of posterior acetabular rimType IIIDislocation with comminution of posterior acetabular rimType IVDislocation with fracture of acetabular floorType VDislocation with fracture of femoral head Stewart and MifordType IDislocation without fractureType IIDislocation with posterior rim fracture (one or more fragments), but the hip is stable after reductionType IIIDislocation with fracture of rim producing gross instabilityType IVDislocation with fracture head or neck of femurType V thompson & Epstein is Subdivided by Pipkin into Four Types (Pipkin Classification)* Femoral head fracture caudal to fovea centralis* Femoral head fracture cephalad to the fovea* Femoral head fracture associated with femoral neck fracture* Type I, II, or III associated acetabular fractureNOTE Thomson & Epstein, and Stewart & Milford are posterior dislocation injuries of hip and Pimpkins fracture is fracture of femoral head (& / or neck) in posterior dislocation injuries.
Anterior dislocation of hip
Posterior dislocation of hip
Femur neck fracture
Femur head fracture
Congenital Dislocation of Hip (C.D.H.)