Initial treatment of traumatic hip dislocations in the adult.

The initial treatment of traumatic hip dislocations is critical to successful treatment of this injury. It generally is agreed that prompt reduction with the patient under anesthesia or sedation is required. Delay in reduction of posterior hip dislocations is associated with avascular necrosis of the hip. Occasionally the hip dislocation will be irreducible. Various methods to reduce hip dislocations have been described in the literature. The superiority of one particular technique has not been shown and the choice of reduction maneuver must be tailored to the condition of the patient. Traumatic hip dislocations often are associated with multiple injuries that may limit the options available for initial treatment of the hip dislocation. Adherence to general principles of skeletal reduction will increase the ease of reduction and decrease the risk of iatrogenic injury during reduction. Additional clinical and radiographic evaluation of the hip that was reduced often is necessary to determine whether subsequent open treatment is required.