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The Captain Morgan technique for the reduction of the dislocated hip
Gregory W Hendey1, Arturo Avila
1University of California San Francisco-Fresno, Department of Emergency Medicine, USA. ghendey@fresno.ucsf.edu
Insights
A novel technique, the Captain Morgan, effectively reduces acute hip dislocations in the emergency department (ED). This method proved successful in 92% of cases, offering a valuable new option for hip dislocation management.
Area of Science:
- Orthopedic Surgery
- Emergency Medicine
- Trauma Care
Background:
- Acute hip dislocation is a common emergency department presentation.
- Traditional reduction techniques can be challenging and may require procedural sedation.
- A novel, minimally invasive technique may improve patient outcomes and reduce resource utilization.
Purpose of the Study:
- To present the experience with a novel technique for acute hip dislocation reduction in the emergency department.
- To evaluate the efficacy and safety of the Captain Morgan technique.
- To determine the success rate of this technique in a diverse patient population.
Main Methods:
- Retrospective review of 77 patients with hip dislocation treated in the ED over 4 years.
- Data collected included patient demographics, reduction technique, outcomes, and presence of prosthetic hip.
- The Captain Morgan technique involves physician knee placement behind the supine patient's flexed knee with anterior force and rotation.
Main Results:
- The Captain Morgan technique was used in 13 patients, achieving successful reduction in 12 (92%).
- Overall ED reduction success rate was 87% across all techniques.
- No neurovascular complications or knee injuries were reported.
Conclusions:
- The Captain Morgan technique is a novel and effective method for acute hip dislocation reduction in the ED.
- This technique demonstrates a high success rate and a favorable safety profile.
- Physicians should consider this method as a primary option for acute hip dislocation management.
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.
