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The Captain Morgan Technique for the Reduction of the Dislocated Hip

2012; Elsevier BV; Volume: 60; Issue: 1 Linguagem: Inglês

10.1016/j.annemergmed.2012.01.028

1097-6760

Faisal Almazroua, Gary M. Vilke,

Orthopedic Infections and Treatments

We read with interest the recently published article titled “The Captain Morgan Technique for the Reduction of the Dislocated Hip” by Hendey and Avila.1Hendey G.W. Avila A. The Captain Morgan technique for the reduction of the dislocated hip.Ann Emerg Med. 2011; 58: 536-540Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar We agree with the utility, success, and overall safety of this technique. However, we had a complication when reducing a hip in an elderly wheelchair-bound patient and observed that the authors did not comment that in performing the reduction, care must be given to not use the “Captain's knee” as a fulcrum to reduce the hip. Pushing down on the patient's lower leg while having the knee fixed puts a great deal of tension on the knee and in our case created the complication of tearing the knee ligaments. We want readers to understand the potential for this complication if the technique is not followed carefully because it is common for novice users to try to create more force on the hip by pushing the leg down instead of raising the “Captain's knee” upward. The Captain Morgan Technique for the Reduction of the Dislocated HipAnnals of Emergency MedicineVol. 58Issue 6PreviewWe present our experience with a novel technique for the reduction of acute hip dislocation in the emergency department (ED). Full-Text PDF In replyAnnals of Emergency MedicineVol. 60Issue 1PreviewI thank Drs. Almazroua and Vilke for their comments on the Captain Morgan technique for reducing a dislocated hip. They have correctly pointed out that the knee should not be used as a fulcrum, with the main force coming from downward pressure on the patient's ankle. Instead, the main force should be an upward or lifting force generated by one's gastrocnemius and soleus muscles. Although I have not personally encountered a complication as described by the authors, I agree with their concern that using the knee as a fulcrum could impart a great deal of force to the patient's knee, risking ligamentous injury. Full-Text PDF