In this section
Hip dislocation - Emergency Department
Subsequent review appointments
Discharge advice to parents
2 weeks post-reduction with x-ray
Consideration of bone scan done at 3-7 days post-injury to assess vascular status of the femoral head
At 6 weeks with x-ray then again at 12 weeks with x-ray
Follow-up visits after 6 weeks should be in the consultant clinic
Consider bone scan/MRI at 6-12 weeks to assess for avascular necrosis (AVN) of the femoral head
Follow-up will be conducted in the consultant clinic. Patients should be followed 1-2 years post-injury before being discharged from care
Avascular necrosis (AVN) of the femoral head is the most common complication. This can occur due to disruption of the blood supply to the femoral head as a result of the injury. The risk is reported between 3-15%. The risk has been shown to be significantly higher if the hip is not reduced within 6 hours post-injury.
Other complications are less common, but include nerve injury (2 -10%), femoral head over growth (coxa magna), osteoarthritis (those injuries with acetabular fractures), recurrent dislocation and growth arrest.
After the acute management phase (6 weeks), further follow-up visits should be in the consultant clinic.
These patients should be followed in the consultant clinics after the initial check. Patients without any complications two years post-injury can be discharged from the consultant clinic.
McCarthy JM, Noonan K. Fractures and traumatic dislocations of the hip in children. In Rockwood and Wilkins' Fractures in Children, 7th Ed. Beaty JH, Kasser JR (Eds). Lippincott Williams & Wilkins, Philadelphia 2010. p.769-96.
Vialle R, Odent T, Pannier S, et al. Traumatic hip dislocation in childhood. J Pediat Ortho 2005; 25(2): 138-44.