Hip Injuries

MINORS MANUAL

Hip injuries can range from minor strains to severe trauma affecting both the joint and surrounding structures. In the emergency department, a rapid and accurate evaluation is crucial due to the complex anatomy of the hip and its impact on patient mobility and quality of life. Below is an overview of the main hip injuries and their initial management.

Category	Description
Hip Fractures
Femoral Head Fracture	Fracture at the top of the femur where it articulates with the acetabulum. Symptoms include severe groin pain, inability to move the leg, and possible deformity (often in external rotation and shortening).
Femoral Neck Fracture	Fracture in the region just below the femoral head. Symptoms include groin pain, inability to bear weight, and limited leg movement.
Intertrochanteric Fracture	Fracture between the greater and lesser trochanters of the femur. Symptoms include hip pain, inability to move the leg, and possible deformity.
Greater and Lesser Trochanter Fracture	Fracture of the bony prominences of the femur. Fractures of the greater trochanter cause pain in the hip and buttock, while lesser trochanter fractures cause groin and inner thigh pain.
Hip Dislocations
Posterior Hip Dislocation	Dislocation of the femoral head backward from the acetabulum. Symptoms include intense hip pain, leg deformity (often in internal rotation and adduction), and difficulty moving the leg.
Anterior Hip Dislocation	Dislocation of the femoral head forward from the acetabulum. Symptoms include hip pain, leg deformity (often in external rotation and abduction), and difficulty moving the leg.
Soft Tissue Injuries
Sprains and Strains	Injuries from sudden movements or excessive strain. Symptoms include pain in the hip region, swelling, and difficulty moving the leg.
Contusions and Bruises	Caused by direct trauma, resulting in pain, swelling, and bruising in the hip region.
Cartilage and Ligament Injuries
Labral Cartilage Injuries	Injuries to the cartilage that stabilises the hip. Symptoms include hip pain, a clicking sensation, and limited range of motion.
Ligament Injuries	Damage to the ligaments stabilising the hip. Symptoms include pain, swelling, and joint instability.
Hip Joint Injuries
Arthritis	Chronic pain and limited hip movement. Symptoms include stiffness, pain that worsens with movement, and a reduced range of motion.
Hip Impingement Syndrome	Impingement between the femoral head and acetabulum, causing pain and restricted movement. Can be caused by bony deformities or cartilage injuries.

Management Protocol

Section	Details
Initial Evaluation
Clinical History and Physical Exam	Determine the mechanism of injury, assess hip pain and function, and check for vascular or neurological impairment.
Immobilisation	Use splints or immobilisation devices to prevent further movement and relieve pain.
Diagnostic Imaging
X-rays	To evaluate fractures and dislocations; may include specific views of the hip and femur.
CT Scan	For detailed evaluation of complex fractures and soft tissue injuries.
MRI	To assess cartilage, ligament, and internal structure injuries.
Initial Treatment
Pain Management	Administer analgesics and anti-inflammatory drugs as needed.
Soft Tissue Injury Treatment	Apply ice, elevate the leg, and use compresses to control swelling.
Surgical Intervention
Fractures and Dislocations	Surgery may be required to realign fractured or dislocated bones and stabilise the hip.
Cartilage and Ligament Injuries	In severe cases, surgery may be necessary to repair or replace damaged structures.
Follow-up and Rehabilitation
Physical Rehabilitation	To restore hip mobility and strength and prevent long-term complications.
Ongoing Monitoring	To assess recovery and prevent complications such as infections or healing issu