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April 21, 2008

Hip Dislocations

Hip_luxation_2 So here we are with our hip joint back in place, taped up in a "sling", but still under anesthesia.  It usually takes a lot of force to dislocate that ball-and-socket joint, so it's unusual to have a big dog like this with her hip dislocated and no other major injuries.  If there's that much force, it usually breaks a few other things, too.  Calli here just has some road-rash and minor cuts to go with her injury.

Hip_out_side2 We medical professionals call this a "coxo-femoral luxation".  "Dislocated hip" just doesn't sound scientific enough for us cool guys.  Most can be replaced without surgery (though some cannot).  Most of the time, the head of the femur (the "ball") is displaced in front and above the socket.  Then the muscles lock up in a spasm, so that even under anesthesia it is really hard to manipulate things back to their normal alignment.  You have to fatigue the muscles by pulling on them and manipulating the hip.   Bigger dogs have bigger muscles and are more difficult to manipulate. It took about 45 minutes for this one on Saturday night (which is unusually long).  I began to wonder whether my own muscles would turn into dishrags before Calli limbered up enough to pop back in place.   It reminded me of when I had my shoulder dislocated the first time -- a complete separation, they called it.  The next day my wrist hurt worse than my shoulder (I think they pulled on it pretty hard when they put things back in place).  It didn't hurt as badly as the shoulder did when it was displaced, though.

Sometimes it feels almost right, so you stop and take an X-ray.  It's still out, so back to the tug-of-war.  When you finally get it right, everything moves smoothly and the muscles relax.  You push hard while you manipulate the hip so that you mash the blood clots out of the socket and make room for the femoral head.  Then you tape things up.  Those muscles and ligaments are really stretched out, and they need time to tighten up and heal a little before the dog puts weight on the limb.

Most dogs return to normal activity in a couple of weeks.  That hip may get arthritis before the other one, but not for a few years (we hope).

Calli went home with her sling, instructions to rest (on a 10-months old Lab: good luck with that!) and pain meds, of course.  We'll be rechecking her soon.

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