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Hip Dislocation Clinical Presentation

  • Author: Matthew Gammons, MD; Chief Editor: Sherwin SW Ho, MD  more...
Updated: Mar 27, 2014


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  • The typical history of a hip dislocation during an athletic event involves 1 of 2 mechanisms.
    • Most commonly, an athlete is running and lands on the feet or flexed knees, striking the ground while the hip is flexed, adducted, and internally rotated. This type of injury has been well documented in contact sports in which participants are tackled at high speeds and land out of control with other players piling on top of them (eg, football, rugby). A similar injury may occur during high-speed racecar driving accidents.
    • The second mechanism involves an athlete landing in the splits, with the hip flexed, abducted, and externally rotated. This type of injury is more likely to be seen during sports involving jumping and landing (eg, basketball, gymnastics).
    • The mechanism in skiing and snowboarding injuries is not well described and complex, due to high speeds and additional equipment, but it is likely similar to the aforementioned mechanisms.
  • Patients often present in obvious severe pain in the hip region and upper leg. They may also complain of knee, lower leg, or even back pain.
  • Patients usually complain of the inability to walk or move their leg about the hip joint.
  • Patients may complain of numbness and/or tingling in the legs in cases involving neurovascular damage.


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  • Hip dislocations usually present with the athlete complaining of severe pain around the hip and proximal thigh.
  • Anterior hip dislocations may present in 2 different ways.
    • Superiorly displaced dislocations present with the affected hip extended and externally rotated.
    • The inferior type of anterior dislocations presents with the affected hip flexed, abducted, and externally rotated.
  • However, the affected limb of a posterior hip dislocation most commonly appears shortened, internally rotated, and adducted.
  • In those patients whose mechanism of injury suggests a posterior hip dislocation but who have no evidence of a dislocation on examination, a traumatic posterior hip subluxation should be considered. This injury carries many of the risks of a true dislocation and may be overlooked.[13]
  • Assessing the neurovascular status of the injured leg is extremely important. Nerve injury, particularly neurapraxia, is not uncommon. The sciatic nerve and the common peroneal division of the sciatic nerve are most often injured in posterior dislocations. Simple observation and palpation for bony deformity, skin color, and temperature provides clues to the vascular status of the leg. Test reflexes, strength, and sensation in the affected leg, and palpate for femoral and distal pulses.
  • The physician should also examine the patient carefully for other bony injuries. A significant amount of force is required to dislocate a hip. Studies of motor vehicle accidents have shown hip dislocations are commonly associated with knee injuries such as fractures, dislocations, and ligamentous damage. Whether or not sport-related hip dislocations have the same rates of associated knee injuries is not known; however, a careful knee examination should be performed on all patients with hip dislocations.

Related Medscape Reference topics

Fracture, Knee

Knee Injury, Soft Tissue

Peripheral Nerve Injuries

Traumatic Peripheral Nerve Lesions



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  • High-speed, high-impact sports are the most common setting for hip dislocations.
    • Unsafe and poorly maintained playing surfaces may add to the risk of participating in high-impact sports. For instance, wet surfaces provide an environment where athletes are more prone to lose control of their bodies while running and jumping. However, no evidence exists to link these factors with an increased incidence of hip dislocations.
    • One case report describes a basketball player who slipped on a wet court and dislocated his hip.[5]
  • Although warming up before an activity and stretching on a regular basis may help prevent some sporting injuries, no evidence suggests that this decreases the risk of hip dislocation.
  • No correlation exists between athletic experience and hip dislocations.
Contributor Information and Disclosures

Matthew Gammons, MD Assistant Clinical Professor, Department of Family and Community Medicine, Medical College of Wisconsin; Medical Director, Castleton State College; Consulting Staff, Vermont Orthopaedic Clinic and Killington Medical Clinic

Matthew Gammons, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, American Society of Mechanical Engineers

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

Gerard A Malanga, MD Founder and Partner, New Jersey Sports Medicine, LLC and New Jersey Regenerative Institute; Director of Research, Atlantic Health; Clinical Professor, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Fellow, American College of Sports Medicine

Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Institute of Ultrasound in Medicine, North American Spine Society, International Spine Intervention Society, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine

Disclosure: Received honoraria from Cephalon for speaking and teaching; Received honoraria from Endo for speaking and teaching; Received honoraria from Genzyme for speaking and teaching; Received honoraria from Prostakan for speaking and teaching; Received consulting fee from Pfizer for speaking and teaching.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Alexander Zlidenny, MD, and Federico E Vaca, MD, FACEP, to the development and writing of this article.

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Normal anteroposterior (AP) pelvis radiograph.
Right posterior hip dislocation in a young woman following a high-speed motor vehicle collision (MVC).
Fracture-dislocation of the right hip. The bony fragments are likely part of the acetabulum.
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