In reply
2012; Elsevier BV; Volume: 60; Issue: 1 Linguagem: Inglês
10.1016/j.annemergmed.2012.01.027
ISSN1097-6760
Autores Tópico(s)Bone fractures and treatments
ResumoI 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. As we did describe in our article, this is one of the primary ways in which our method differs from the original report by Lefkowitz, which advocated “downward pressure applied to the patient's ankle.”1Lefkowitz M. A new method for reduction traumatic dislocations.Orthop Rev. 1993; 2: 253-256Google Scholar Again, I thank you for emphasizing this important point, and may the Captain go with you. The Captain Morgan Technique for the Reduction of the Dislocated HipAnnals of Emergency MedicineVol. 60Issue 1PreviewWe read with interest the recently published article titled “The Captain Morgan Technique for the Reduction of the Dislocated Hip” by Hendey and Avila.1 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. Full-Text PDF
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