This relatively recently described hip reduction technique would be of greater interest to our friends in the ED, but might make you look like a champion in the course of attending a trauma resus. Out of theatre hip reductions are notoriously tricky, require a fairly beefy proceduralist (Thank Heaven for orthopods), a good deal of sedation and have a fair degree of risk of injury to both patient and practitioner. So here’s an article that may be of interest to those of you who enjoy a bit of rolled-up shirt-sleeve oneupmanship … |
In December 2011, the Annals of Emergency Medicine published a paper reviewing 4 years of hip reductions and looked particularly at a novel technique called the “Captain Morgan hip reduction technique” (Yes, it’s named after a brand of rum. Look at the bottle’s label and you’ll work it out). You can watch a short video of the technique here
The technique is gaining traction (Oh, the humor!) and has received attention on The Trauma Professional’s Blog and Graham Walker’s (of TheNNT) G-Mergency blog.
It looks like a great technique; much easier on both patient and proceduralist, compared to the standard technique. However, I’d be careful with elderly patients or bone fragility disorders, as the technique describes pushing down on the ankle to increase leverage of the hip joint, which potentially increases the torque force across the tibia and fibula with the possibility of fracture. Also, in the Annals paper, the one case do failed reduction occurred in a patient with an anterior ace tabular fracture and a bone fragment in the joint space, which as expected required operative repair and reduction.