Hip Dislocation

• Posterior: flexed, adducted, internally rotated limb (classic)
• Check sciatic nerve before and after reduction
• AP pelvis and dedicated hip views; CT after reduction to assess wall fragments, femoral head, and concentricity
• Examine the ipsilateral knee — dashboard mechanisms injure both

Reduce urgently under adequate sedation or in the OR if closed attempts fail. Post-reduction incongruity, large wall fragments, incarcerated fragments, or recurrent instability push toward operative acetabular / head care.

Do not force repeated closed attempts against a block — that is how you create a femoral neck fracture or worse osteochondral injury.

• Emergent closed reduction with NV exam before and after
• Post-reduction imaging; CT when operative questions remain
• Traction if unstable pending definitive fixation
• ORIF of associated acetabular wall / femoral head injuries as indicated
• Protected mobilization per stability after treatment

• Time to reduction matters for AVN risk counseling
• Sciatic nerve exam is mandatory
• CT after reduction for associated injury
• Incarcerated fragment → incongruent reduction