HIP FRACTURES-HIP PRECAUTIONS

SUMMARY

1. In a posterior THA approach, total hip precautions must be followed to avoid dislocation: avoid hip flexion over 90°, hip adduction past midline, and extreme hip internal rotation.

2. A high chair height is preferred to a low height in order to reduce hip flexion and potential for posterior hip dislocation.

3. After an anterior approach, additional precautions include avoidance of hip extension and external rotation (i.e. opposite of posterior THA precautions).

4. Dislocation after hip replacement occurs at varying frequency. Prompt reduction under GA will likely preserve the replacement.

5. Sepsis is a cause of dislocation after hip replacement and must be considered.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.