An orthogonal view is necessary to determine the next best step because it is not possible to determine if this hip luxation is dorsal or ventral with only the VD.
Conservatively treat craniodorsal coxofemoral (hip) luxations (most common) with closed reduction and an Ehmer sling. Typically presents as a non-weight-bearing lameness, usually after blunt force trauma, (e.g., being hit by a car).
Occasionally ventral luxations occur and an Ehmer sling predisposes these to re-luxation, as it positions the limb in an abducted, externally rotated position. Instead, use hobbles to prevent abduction and re-luxation.
In this case closed reduction is appropriate as the injury is recent (less than 24-48 hr since it occurred). Additionally, the hip anatomy is normal, with no signs of avulsion fragments, hip dysplasia, or osteoarthritis.
Closed reduction is associated with a re-luxation rate of ~50%, treated with open reduction and stabilization: e.g., toggle pinning, iliofemoral suture, capsulorrhaphy, trochanteric transposition, and prosthetic joint capsule.
Risk of re-luxation after closed reduction is higher with chronic injuries or dysplastic hips, and these patients are at risk of progressive arthritis. Consider salvage options such as femoral head osteotomy or total hip replacement.
Ehmer slings have a high risk of bandage complications. Carefully monitor post-reduction for sling-related injuries and instruct owners on how to monitor.
Here is some useful information from the University of Illinois about closed reduction of hip luxations, and here is more helpful information from the American College of Veterinary Surgeons.
Image courtesy of Nottingham Vet School.
