Gregory W Hendey1, Arturo Avila. 1. University of California San Francisco-Fresno, Department of Emergency Medicine, USA. ghendey@fresno.ucsf.edu
Abstract
STUDY OBJECTIVE: We present our experience with a novel technique for the reduction of acute hip dislocation in the emergency department (ED). METHODS: We searched the medical records of all patients with a hip dislocation treated in our ED during a 4-year period. We recorded patient demographics, reduction technique, outcome and disposition, and whether the patient had a prosthetic hip. We reported characteristics of the entire study group and of the subset of patients for whom the Captain Morgan technique was used. Briefly, the technique involves placing the physician's knee behind the supine patient's flexed knee and lifting with anterior force, with rotation as needed. RESULTS: Of 77 patients meeting criteria, the mean age was 46 years (range 5 to 91 years), 35 (45%) had a prosthetic hip, and 67 (87%; 95% confidence interval 77% to 93%) received successful reduction in the ED. In 13 cases, the Captain Morgan technique was specifically described and was successful in 12 (92%; 95% confidence interval 64% to 100%). The single technique failure occurred in a patient with an acetabular fracture with an intra-articular fragment requiring open reduction. There were no described neurovascular complications or injuries to the knee. CONCLUSION: We describe an interesting and novel technique for the reduction of a hip dislocation. Physicians should consider this method a primary technique for the acute management of hip dislocation in the ED.
STUDY OBJECTIVE: We present our experience with a novel technique for the reduction of acute hip dislocation in the emergency department (ED). METHODS: We searched the medical records of all patients with a hip dislocation treated in our ED during a 4-year period. We recorded patient demographics, reduction technique, outcome and disposition, and whether the patient had a prosthetic hip. We reported characteristics of the entire study group and of the subset of patients for whom the Captain Morgan technique was used. Briefly, the technique involves placing the physician's knee behind the supine patient's flexed knee and lifting with anterior force, with rotation as needed. RESULTS: Of 77 patients meeting criteria, the mean age was 46 years (range 5 to 91 years), 35 (45%) had a prosthetic hip, and 67 (87%; 95% confidence interval 77% to 93%) received successful reduction in the ED. In 13 cases, the Captain Morgan technique was specifically described and was successful in 12 (92%; 95% confidence interval 64% to 100%). The single technique failure occurred in a patient with an acetabular fracture with an intra-articular fragment requiring open reduction. There were no described neurovascular complications or injuries to the knee. CONCLUSION: We describe an interesting and novel technique for the reduction of a hip dislocation. Physicians should consider this method a primary technique for the acute management of hip dislocation in the ED.
Authors: Vincenzo Giordano; Marcos Giordano; Renato Caravellos Glória; Felipe Serrão de Souza; Paulo di Tullio; Marco Martins Lages; Hilton Augusto Koch Journal: J Clin Orthop Trauma Date: 2017-07-29