Pediatric emergency medicine trisk 3493 3493
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FIGURE 111.35 Radiographs taken following closed reduction of a right hip dislocation. A:
The plain film demonstrates residual widening of the joint space (arrows ). B: Widening is also
apparent with magnetic resonance imaging, as is entrapment of a portion of the posterior joint
capsule (arrow ). Under general anesthesia, further efforts at closed reduction were successful.
Treatment of hip dislocation is closed reduction. This will usually be done by
an orthopedist under procedural sedation in the ED or in the operating room
under general anesthesia. In adolescents, reduction under anesthesia is
recommended as occult epiphyseal injury may be present in this age group with
hip dislocation, and epiphyseal separation may occur during reduction. However,
given the importance of a timely reduction, in select cases, hip reduction may be
performed by emergency clinicians. For a posterior hip dislocation reduction, the
hip and knee should be flexed to 90 degrees and with the pelvis stabilized,
