Trauma of the Hip and Femoral Shaft
Hip dislocations are usually high-energy injuries. Posterior dislocations are the most common and often associated with sciatic nerve injury. The classical clinical picture includes pain, shortening, and a flexion/adduction/internal rotation posture of the lower extremity. A plain AP pelvis x-ray should confirm the diagnosis and rule out associated bony injuries. Anesthesia or sedation, preferably with muscle relaxation, is necessary for reduction. Trolleys and OR tables are narrow and unstable, making it safer to place the patient on a mattress on the floor for reduction, while an assistant applies downward pressure on the anterior superior iliac spines. Traction in line with the axis of the femoral displacement—the Allis maneuver—will reduce the dislocation, usually with a clunk after which the leg is extended and externally rotated (https://www.youtube.com/watch?v=sGQZaqB48rw).
- 6.Young S, Lie SA, Hallan G, Zirkle LG, Engesaeter LB, Havelin LI. Low infection rates after intramedullary nail operations in 55 low- and middle-income countries: validation of the Surgical Implant Generation Network (SIGN) online surgical database. Acta Orthop. 2011;82(6):737–43.CrossRefGoogle Scholar