POSTERIOR DISLOCATION OF HIP
A 30-year old male was brought to the casualty following a road traffic accident. On physical examination his right lower limb was short, internally rotated, and flexed and adducted at the hip. What is the most likely diagnosis?
| A |
Fracture neck of femur |
|
| B |
Trochanteric fracture |
|
| C |
Posterior dislocation of hip |
|
| D |
Central fracture dislocation of hip |
A 30-year old male was brought to the casualty following a road traffic accident. On physical examination his right lower limb was short, internally rotated, and flexed and adducted at the hip. What is the most likely diagnosis?
| A |
Fracture neck of femur |
|
| B |
Trochanteric fracture |
|
| C |
Posterior dislocation of hip |
|
| D |
Central fracture dislocation of hip |
Since the right limb of the man appeared short, internally rotated, flexed and adducted at the hip he has suffered a posterior dislocation of hip following the accident.
Ref: Oxford American Handbook of Emergency Medicine By Jeremy Brown, Chapter 214.
Which of the following attitude will be seen in a patient with posterior dislocation of hip?
| A |
Flexion, Abduction, Internal rotation |
|
| B |
Flexion, Adduction, Internal rotation |
|
| C |
Flexion, Abduction, External rotation |
|
| D |
Flexion, Adduction, External rotation |
Which of the following attitude will be seen in a patient with posterior dislocation of hip?
| A |
Flexion, Abduction, Internal rotation |
|
| B |
Flexion, Adduction, Internal rotation |
|
| C |
Flexion, Abduction, External rotation |
|
| D |
Flexion, Adduction, External rotation |
Dislocations are usually posterior, and occasionally anterior, or central through the acetabulum.
Posterior dislocation: Hip is flexed, adducted, and internally rotated, and leg is shortened.
Anterior dislocation: Hip is flexed, abducted, and externally rotated, and leg is shortened.
Central dislocation: Trochanter is displaced medially. One may be able to feel the head of femur rectally. There is no shortening.
Flexion, adduction and internal rotation is characteristic posture in
| A |
Anterior dislocation of hip joint |
|
| B |
Posterior dislocation of hip joint |
|
| C |
Fracture of femral head |
|
| D |
Fracture shaft of femur |
Flexion, adduction and internal rotation is characteristic posture in
| A |
Anterior dislocation of hip joint |
|
| B |
Posterior dislocation of hip joint |
|
| C |
Fracture of femral head |
|
| D |
Fracture shaft of femur |
B i.e. Posterior dislocation of hip joint
The pain around the hip with flexion, adduction & internal rotation of lower limb in a young adult after a road traffic accident is suggestive of:
| A |
Intracapsular fracture of the femoral neck |
|
| B |
Extra capsular fracture of the femoral neck |
|
| C |
Posterior dislocation of hip |
|
| D |
Anterior dislocation of hip |
The pain around the hip with flexion, adduction & internal rotation of lower limb in a young adult after a road traffic accident is suggestive of:
| A |
Intracapsular fracture of the femoral neck |
|
| B |
Extra capsular fracture of the femoral neck |
|
| C |
Posterior dislocation of hip |
|
| D |
Anterior dislocation of hip |
C i.e. Posterior dislocation
Dashboard injury results in
| A |
Anterior dislocation of hip |
|
| B |
Posterior dislocation of hip |
|
| C |
Central dislocation of hip |
|
| D |
Fracture neck femur |
Dashboard injury results in
| A |
Anterior dislocation of hip |
|
| B |
Posterior dislocation of hip |
|
| C |
Central dislocation of hip |
|
| D |
Fracture neck femur |
B i.e. Posterior dislocation of hip
Vascular sign of Narath is noticed in
| A |
Fracture neck of femur |
|
| B |
Perthes disease |
|
| C |
Posterior dislocation of hip |
|
| D |
All of the above |
Vascular sign of Narath is noticed in
| A |
Fracture neck of femur |
|
| B |
Perthes disease |
|
| C |
Posterior dislocation of hip |
|
| D |
All of the above |
C i.e. Posterior dislocation of hip
- Vascular sign of narath is positive in posterior dislocation of hip joint.
- Due to posterior dislocation, the hip joint falls on the femoral artery, and this causes feeble or absent femoral pulse.
Deformity of posterior dislocation of hip
| A |
Flexion, adduction, Internal rotation |
|
| B |
Flexion, abduction, external rotation |
|
| C |
Extension abduction, Internal rotation |
|
| D |
Extension adduction, external rotation |
Deformity of posterior dislocation of hip
| A |
Flexion, adduction, Internal rotation |
|
| B |
Flexion, abduction, external rotation |
|
| C |
Extension abduction, Internal rotation |
|
| D |
Extension adduction, external rotation |
A i.e. Flexion, adduction, intenal rotation
A 30-year old male was brought to the casually following a road traffic accident. His physical examination revealed that his right lower limb was short, internally rotated, and flexed and adducted at the hip. The most likely diagnosis is:
| A |
Fracture neck of femur |
|
| B |
Trochanteric fracture |
|
| C |
Central fracture dislocation of hip |
|
| D |
Posterior dislocation of hip |
A 30-year old male was brought to the casually following a road traffic accident. His physical examination revealed that his right lower limb was short, internally rotated, and flexed and adducted at the hip. The most likely diagnosis is:
| A |
Fracture neck of femur |
|
| B |
Trochanteric fracture |
|
| C |
Central fracture dislocation of hip |
|
| D |
Posterior dislocation of hip |
D i.e. Posterior dislocation of hip
Sciatic nerve palsy may occur in the following injury
| A |
Posterior dislocation of hip joint |
|
| B |
Fracture neck of femur |
|
| C |
Trochanteric fracture |
|
| D |
Anterior dislocation of hip |
Sciatic nerve palsy may occur in the following injury
| A |
Posterior dislocation of hip joint |
|
| B |
Fracture neck of femur |
|
| C |
Trochanteric fracture |
|
| D |
Anterior dislocation of hip |
A i.e. Posterior dislocation of hip joint
Flexion, adduction & internal rotation is characteristic posture in:
September 2012
| A |
Anterior dislocation of hip joint |
|
| B |
Posterior dislocation of hip joint |
|
| C |
Fracture femoral head |
|
| D |
Fracture shaft femur |
Flexion, adduction & internal rotation is characteristic posture in:
September 2012
| A |
Anterior dislocation of hip joint |
|
| B |
Posterior dislocation of hip joint |
|
| C |
Fracture femoral head |
|
| D |
Fracture shaft femur |
Ans. B i.e. Posterior dislocation of hip joint
Hip dislocation
- MC type: Posterior dislocation
- Attitude of limb in posterior dislocation:
– Flexion,
– Adduction,
– Internal rotation
- Dislocation, which can be felt of per rectal examination: Central fracture dislocation
The attitude of limb in posterior dislocation of hip joint:
March 2011
| A |
Flexion, adduction and external rotation |
|
| B |
Flexion, adduction and internal rotation |
|
| C |
Flexion, abduction and external rotation |
|
| D |
Flexion, abduction and internal rotation |
The attitude of limb in posterior dislocation of hip joint:
March 2011
| A |
Flexion, adduction and external rotation |
|
| B |
Flexion, adduction and internal rotation |
|
| C |
Flexion, abduction and external rotation |
|
| D |
Flexion, abduction and internal rotation |
Ans. B: Flexion, adduction and internal rotation
An isolated posterior dislocation of the hip is easy to diagnose
The patient presents with a history of severe trauma followed by pain, swelling and deformity (flexion, adduction and internal rotation)
Position of limb in posterior dislocation of hip ‑
| A |
Flexion, abduction & external rotation |
|
| B |
Flexion, adduction & internal rotation |
|
| C |
Flexion, adduction & external rotation |
|
| D |
Flexion, abduction & internal rotation |
Position of limb in posterior dislocation of hip ‑
| A |
Flexion, abduction & external rotation |
|
| B |
Flexion, adduction & internal rotation |
|
| C |
Flexion, adduction & external rotation |
|
| D |
Flexion, abduction & internal rotation |
Ans. is ‘b’ i.e., Flexion, adduction & internal rotation
