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Suggest Treatment For Severe Pain After Suffering From Displaced Hips

Posted on Mon, 1 Feb 2016

Question: My wife displaced her left hip Dec.15. at 8:00 AM.It did not get reduced until 8:00 PM.Reduction was attempted in Comox hospital without success Transferred to CR Hosp.after waiting 5 hrs. for an ambulance.Tried again to put it in.Had to put under general anaesthetic to have the hip put in. She was in hosp. for 5 days on heparin and sent home with none on Dec.20.After 3 visits to emerg. for pain and swelling she was started on heparin shots and warfarin pills and hydromorphone pills on Dec.28.Ultrasound on Dec. 25 showed a blood clot between her ankle and knee.She is still having pain which is not controlled by 2mg. of hydromorphone every 6 hrs.She has started to wear a compression stocking during the day and applying cold 2-3 times a day.What would you suggest to prevent DVT long term damage-Post-Thrombotic Syndrome?What could we do to minimize the pain?

Answered by Dr. Dr. Naveen Kumar Sharma (31 minutes later)

Brief Answer:
She can be shifted on oral anticoagulants

Detailed Answer:
Hello,
i have studied your case and I can assure you that as soon as she will start walking she will be fine. You mentioned that she had only hip dislocation and there is no fracture, So she can start walking with some support.
For deep vein thrombosis she needs to be on oral anticoagulant as heparin is injectable and should not be sued for longer periods.
For pain relief she can take NSAIDS And Tramadol. Pain will improve slowly. Just make surge that there is no infection or inflammation in the veins.
I hope this answer will be useful for you.Let me know if there is any other followup questions.
thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Sharma (21 hours later)

Most important I did not mention that my wife also has a drop foot as a result of her hip dislocation.She cannot move her toe up towards her knee at all.She can move it away from her knee.It stays there until moved upward with help.She has been walking with a two wheeled walker and footbrace since Dec.20 when she came home from the hospital.Is there any special exercises or anything else that will help to restore the nerve and muscle function of her foot?The pain and swelling do not seem to be getting any less after 21 days.

Answered by Dr. Dr. Naveen Kumar Sharma (5 hours later)

Brief Answer:
Foot drop is due to sciatic nerve injury

Detailed Answer:
Hello,
If there is foot drop that means she has also injured her sciatic nerve. This is mostly neuropraxia or stretch injury and it improves with in three to four months. Till then she can be given night splint or foot drop splint so that his foot does not become deformed.
She should also take Pregabalin M at night time. There is no need for wheel chair as she can walk with walker without putting weight on affected limb. We should try to make her stand so there is decrease in swelling.
I hope this answer will be useful for you. Let me know if there is any other followup questions.
thanks

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar