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Abstract: The patient, a 75-year-old male, came to the hospital with severe pain and limited movement of the hip joint due to a car accident, and was diagnosed with hip dislocation after physical examination and radiographic examination. After detailed communication with the patient about his condition, he agreed to be admitted to the hospital for manual repositioning, together with skin traction and muscle functional exercise of the lower limbs. After treatment, the patient’s hip pain, deformity, restricted movement and shortening of the lower limbs improved and he gradually resumed normal walking.
Basic information】Male, 75 years old
Type of disease】Hip dislocation
Hospital】Harbin First Hospital
Consultation time】November 2021
Treatment plan】Manipulation + lower limb skin traction + lower limb muscle function exercise
Treatment Period】7 days of hospitalization, 1 month of review after resetting
Effectiveness】Hip pain, deformity, limitation of movement, and shortening of the lower limb improved, and normal walking gradually resumed.
I. Initial consultation
The patient came to our hospital because of a car accident. At the time of the accident, the patient was in a flexed knee and hip flexion position, and the knee joint was subjected to violent impact, resulting in severe pain and limited movement of the hip joint. Physical examination revealed that the patient was unable to stand or walk normally and had a shortened lower limb deformity. After communicating with the patient about the specific situation, he agreed to be admitted to the hospital for treatment.
II. Treatment process
The patient was recommended to undergo immediate repositioning, and after the patient agreed, the repositioning treatment was performed under general anesthesia. The patient was placed in a supine position, the pelvis was fixed, the patient stood facing the patient, the hip and knee were flexed 90° at the same time, the popliteal fossa was fixed with both hands, continuous lower limb traction was performed, and after the muscles around the hip joint were relaxed, the hip joint was externally rotated so that the femoral head was reabsorbed into the hip joint. After completion of the reset, the hip deformity disappeared and the hip joint activity was then restored. After successful reset, the patient kept the hip joint in the straight position and continued to perform skin traction on the lower limb for 3 weeks to promote the repair of the tissues around the hip joint and to cooperate with the functional exercise of the lower limb muscles.
III. Treatment effect
The hip joint dislocation was cured through hip joint manipulation and continuous skin traction of the lower limb, and the hip joint pain, deformity, limitation of movement and shortening of the lower limb were all improved. After 7 days of hospitalization, the patient had no discomfort and was discharged from the hospital. On review 1 month after manual resetting, the patient’s hip joint range of motion, hip joint stability and muscle strength around the hip joint were restored, and the quality of life was significantly improved. on review 3 months later, the patient could walk normally without crutches, and could even complete simple exercises, such as jogging.
IV. Precautions
After the comprehensive treatment, the patient’s hip joint was successfully reset, the pain and deformity symptoms were relieved to disappeared, and the quality of life was improved, which makes us as doctors feel happy. However, the patient still needs to maintain mild abduction and extension of the hip joint as well as continuous traction after discharge to ensure complete repair of the tissues around the hip joint and to avoid dislocation of the hip joint again. Be careful not to sit up or leave the bed too early, otherwise it may cause the acetabular labral tear to be difficult to repair, affecting the weight-bearing activities of the hip joint and even reducing the patient’s hip joint movement ability, which will lead to surgery and prolong the recovery time of the hip joint dislocation.
V. Personal insight
In this case, the hip joint dislocation occurred mainly because the hip joint was severely injured by violence, so it is necessary to pay attention to protecting the hip joint in daily life and avoid crossing the legs when riding in a car. At the same time, the exercise of the muscles around the hip joint should be strengthened to enhance the stability of the hip joint. After hip dislocation occurs, you should go to the hospital immediately so that you can choose the appropriate treatment method according to your specific condition, such as manual resetting. If the delay is too long, it will be more difficult to reset and the prognosis will be poor.