Hip Luxations

Hip luxations typically result in craniodorsal displacement of the femoral head relative to the acetabulum (Figure 1).  Less than 50% of hip luxations can be reduced via closed reduction and maintained in a reduced position long enough for healing of the damaged soft tissues to occur (Figure 2).

Surgery is utilized when closed reduction fails to maintain hip reduction.A toggle bolt repair is recommended to replace the function of the round ligament. A toggle pin secured to a strand of monofilament is placed medial to the acetabulum via a hole drilled through the fovea capitis. A second hole is drilled from the attachment point of the round ligament on the femoral head through the femoral neck and exiting just distal to the trochanter. The strands of monofilament are passed through this hole, the hip reduced and the strands tied around a second toggle bolt along the lateral femoral cortex (Figure 3). Joint capsule tears are reconstructed and the limb placed in a modified ehmer sling PO.

Compared to the other surgical techniques, the toggle bolt repair is reported to provide the most stability to maintain hip reduction until surrounding soft tissues heal.