A hip dislocation, where the ball of the thighbone (femoral head) is forced out of the socket (acetabulum), is a severe injury and a medical emergency. The common term “resetting a hip” medically refers to reduction, which involves carefully maneuvering the femoral head back into the acetabulum. Attempting this complex procedure outside of a controlled clinical environment is extremely dangerous and can cause permanent damage to nerves, blood vessels, and the joint itself. Immediate medical attention is the only safe response to a suspected hip dislocation.
Recognizing Signs of Severe Hip Injury
A true hip dislocation is typically the result of significant trauma, such as a high-speed motor vehicle accident or a substantial fall. The most immediate symptom is intense, excruciating pain in the hip and groin area that makes any movement nearly impossible. This acute pain is far more severe than a simple muscle strain.
The injured leg often presents with a visible deformity, indicating a dislocation. In the most common type, a posterior dislocation, the leg may appear shortened, internally rotated (turned inward), and slightly bent at the hip. An anterior dislocation, though less common, typically results in the leg being externally rotated (turned outward) and held slightly away from the body.
The patient will be unable to bear any weight on the affected limb, and movement drastically worsens the pain. Numbness or tingling in the leg or foot suggests possible injury to the sciatic nerve, which runs close to the hip joint.
Stabilizing the Hip While Awaiting Medical Assistance
While awaiting medical personnel, the goal is to prevent further damage to the compromised joint and surrounding structures. The most important action is to keep the injured person completely still. Any unintended movement can increase soft tissue damage or worsen an associated fracture. Do not attempt to manipulate, push, or pull on the injured leg, regardless of how it appears.
The patient should be kept in the position of comfort they instinctively found after the injury. Use pillows, rolled-up blankets, or jackets to carefully support the injured leg in this specific position. Do not attempt to change the leg’s alignment. Limiting movement of the joint is paramount. Applying a cold pack wrapped in a cloth may help manage swelling and discomfort.
Cover the patient with a blanket to prevent shock, even if the environment is not cold. If conscious, the person should not be given anything to eat or drink. They will likely require sedation or general anesthesia for the reduction procedure upon reaching the hospital. Monitor the patient’s level of consciousness and breathing continuously until emergency medical services take over.
The Medical Reality of Hip Reduction
Hip reduction must be performed by a medical professional due to the complex anatomy and risk of complications. The hip joint is highly stable, encased by powerful ligaments and muscles, requiring tremendous force to dislocate it. Immediately after injury, the surrounding muscles go into severe spasm, locking the femoral head out of the socket.
Forcing the joint back without muscle relaxation risks tearing the labrum or fracturing the femoral head or socket. The greatest danger is damage to neurovascular structures, particularly the sciatic nerve. Sciatic nerve injury can result in foot drop or permanent paralysis, occurring in about 10% of posterior hip dislocations.
A dislocated hip can also tear the blood vessels supplying the femoral head, such as the medial circumflex femoral artery branches. If the blood supply is compromised, the bone tissue can die, a condition known as avascular necrosis (AVN). The risk of AVN increases significantly if the hip is not reduced within six to eight hours. Therefore, reduction requires deep sedation or general anesthesia to fully relax the muscles, which is only available in a hospital setting.
How Medical Professionals Perform a Hip Reduction
Upon arrival at the emergency department, the medical team confirms the injury and rules out associated fractures using imaging, typically an X-ray or CT scan. Powerful intravenous pain medication and sedation or general anesthesia are administered. This ensures complete muscle relaxation before the procedure begins. Relaxation is necessary to overcome spasms and allow the joint to move without causing further soft tissue damage.
The reduction uses specific, controlled maneuvers, such as the Allis or Stimson technique. These involve stabilizing the pelvis while applying specific traction and rotation to the leg. The maneuvers gently guide the femoral head back into the acetabulum along the safest path. A successful reduction is often confirmed by a palpable or audible “clunk” as the joint relocates.
Immediate post-reduction X-rays and often a CT scan are performed afterward. These confirm the femoral head is perfectly seated within the socket. Imaging also checks for bone fragments or associated fractures that may have occurred during the injury or reduction attempt. The patient is then monitored for signs of nerve or blood vessel compromise. Post-reduction weight-bearing status is determined based on the initial injury’s severity.