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[Conditions](https://durgical.com/en/conditions/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/)

# Hip dislocation

A hip dislocation is when the ball of the [femur](https://durgical.com/en/anatomy/femur/) comes out of the hip socket; in a natural hip it takes major trauma and is usually backward.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Hip bone](https://durgical.com/en/anatomy/hip-bone/)
- [Femur](https://durgical.com/en/anatomy/femur/)
- [Hip capsule](https://durgical.com/en/anatomy/articular-capsule-of-hip-joint/)
- [Sciatic nerve](https://durgical.com/en/anatomy/sciatic-nerve/)
- [Ligament of the femoral head](https://durgical.com/en/anatomy/ligament-of-head-of-femur/)
- [Acetabular labrum](https://durgical.com/en/anatomy/acetabular-labrum/)
- [Circumflex femoral arteries](https://durgical.com/en/anatomy/medial-circumflex-femoral-artery/)
- [Iliofemoral ligament](https://durgical.com/en/anatomy/iliofemoral-ligament/)
- [Ischiofemoral ligament](https://durgical.com/en/anatomy/ischiofemoral-ligament/)
- [Femoral head cartilage](https://durgical.com/en/anatomy/articular-cartilage-of-femoral-head/)

## Why it happens

- [Infarction: red vs white, and what decides the damage](https://durgical.com/en/general-pathology/infarction-red-vs-white-and-what-decides-the-damage/)

## What it is

Displacement of the femoral head out of the acetabulum. In a native hip it needs high-energy trauma, and most dislocations are posterior.

## Who gets it

A typical injury of young adults in traffic collisions, including motorcycle crashes. Dislocation of a hip replacement is a separate, lower-energy problem in older adults.

## Causes

- Posterior: axial force on the flexed, adducted knee and hip, as when the knee hits the dashboard
- Anterior: forced abduction and external rotation
- Falls from height and sports at high speed

## Risk factors

- Traffic collisions without seat belts
- Motorcycle crashes
- Previous hip replacement (prosthetic dislocation)
- Hip dysplasia

## Pathophysiology

The hip is a deep, stable ball-and-socket joint, so dislocation tears the capsule and the ligament of the head of the femur and often fractures the acetabular rim or femoral head. Stretching or kinking of the retinacular vessels threatens the blood supply of the head, and the longer it stays out, the higher the risk of avascular necrosis.

## Classification

- Posterior (most common), anterior or central (fracture-dislocation through the acetabulum)
- Simple or with associated fractures (acetabular wall, femoral head: Pipkin classification)
- Thompson-Epstein classification for posterior dislocations

## Symptoms and signs

- Severe hip pain and inability to move the leg after trauma
- Posterior: leg shortened, flexed, adducted and internally rotated
- Anterior: leg abducted and externally rotated
- Foot drop or numbness if the [sciatic nerve](https://durgical.com/en/anatomy/sciatic-nerve/) is injured

## Red flags

- Sciatic nerve deficit, mainly in its fibular division (foot drop)
- Associated injuries: knee ([patella](https://durgical.com/en/anatomy/patella/), PCL), femoral shaft, acetabulum, other body regions
- Irreducible dislocation or a fracture fragment in the joint
- Delay to reduction beyond about 6 hours (higher risk of avascular necrosis)

## Diagnosis

**Clinical**
ATLS primary survey, then the position of the limb and a careful neurovascular examination before and after reduction.

**Tests**
Trauma laboratory tests as needed; none confirm the dislocation.

**Imaging**
An anteroposterior pelvic radiograph shows it; CT after reduction looks for acetabular or femoral head fractures and loose fragments in the joint.

## Differential diagnosis

- Femoral neck fracture
- Intertrochanteric fracture
- Acetabular fracture
- Femoral shaft fracture
- Dislocated hip replacement

## Goal of treatment

Reduce the hip as an emergency, ideally within about 6 hours, to protect the femoral head blood supply and the sciatic nerve, then restore a stable, congruent joint.

## Treatment

**Acute**
Emergency closed reduction under sedation or anaesthesia, using traction techniques (such as Allis), followed by imaging.

**Surgical**
Open reduction if closed reduction fails, the joint is not congruent or a fragment is trapped.

**Surgical**
Fixation of associated acetabular or femoral head fractures.

**Follow-up**
Repeat neurovascular checks and follow-up for avascular necrosis.

**Rehabilitation**
Protected weight-bearing and physiotherapy for strength and range of motion.

## Complications

- Avascular necrosis of the femoral head
- Sciatic nerve injury
- Post-traumatic osteoarthritis
- Recurrent dislocation
- Heterotopic ossification
- Deep vein thrombosis

## Prognosis

Simple dislocations reduced early often do well. Late reduction, associated fractures and nerve injury raise the risk of avascular necrosis, arthritis and lasting disability.

## Prevention

- Seat belts and road safety measures
- Following hip precautions after hip replacement

## Test yourself

Think of the answer, then tap the question to see it.

## What is the most common direction of traumatic hip dislocation?

Posterior, typically from a dashboard injury with the hip and knee flexed.

## What is the classic limb position in a posterior hip dislocation?

Shortened, flexed, adducted and internally rotated.

## Which nerve is most often injured in a posterior hip dislocation?

The sciatic nerve, mainly its fibular division, causing foot drop.

## Why is a hip dislocation an orthopaedic emergency?

The longer the head stays out, the greater the risk of avascular necrosis; reduction within about 6 hours is the aim.

## Which knee injuries go with a dashboard hip dislocation?

Patellar fracture and posterior cruciate ligament injury, so the knee must be examined.

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## Related conditions

- [Avascular necrosis of the femoral head](https://durgical.com/en/conditions/avascular-necrosis-of-the-femoral-head/)
- [Femoral shaft fracture](https://durgical.com/en/conditions/femoral-shaft-fracture/)
- [Femoral Neck Fracture](https://durgical.com/en/conditions/femoral-neck-fracture/)
- [Hip Osteoarthritis](https://durgical.com/en/conditions/hip-osteoarthritis/)
- [PCL Injury](https://durgical.com/en/conditions/pcl-injury/)
- [Patellar fracture](https://durgical.com/en/conditions/patellar-fracture/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Posterior Hip Dislocation](https://www.ncbi.nlm.nih.gov/books/NBK459319/) (StatPearls (NCBI Bookshelf), 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/conditions/hip-dislocation/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/hip-dislocation/