Dislocations- Hip and Knee

 

Hip & Knee Dislocations: NEET PG High-Yield

Orthopedic Trauma: Emergency Assessment

1. Hip Dislocation

Type Clinical Presentation
Posterior (90%) Flexed, adducted, and internally rotated. Sciatic nerve at risk.
Anterior Flexed, abducted, and externally rotated. Femoral nerve/vessels at risk.

2. Knee Dislocation

  • Emergency Priority: It is a limb-threatening injury. Rule out popliteal artery injury immediately.
  • Classification: Based on the direction of the tibia relative to the femur (Anterior is most common).
  • Examination: Check the distal pulses (Doppler if weak) and the Common Peroneal Nerve (most commonly injured nerve).
  • Management: Immediate closed reduction and stabilization (external fixator). Vascular consultation is mandatory if pulses are abnormal or asymmetric.

3. High-Yield NEET PG Pearls

  • Hip Reduction: Must be performed within 6 hours to minimize the risk of Avascular Necrosis (AVN) of the femoral head.
  • “Dashboard Injury”: Classic mechanism for posterior hip dislocation.
  • Knee Dislocation Complication: Popliteal artery injury is the most critical complication; if suspected, perform an emergency CT angiography.
  • Multiligament Injury: Knee dislocation almost always involves at least two major ligaments (ACL and PCL).