Quick refreshers before your next procedure

Posterior Hip Dislocations

Over-Under (Whistler/Tulsa/Rochester) Technique

Time: 20 mins
Personnel Required:
3
Equipment Required:
1. adequate analgesia 
2. If adding procedural sedation, end tidal CO2 + monitor
3. 2 bedsheets

Steps: 

1. Assistant 1 + 2: Place bedsheets over the patients hips and cross it under the bed like a belt. (not shown in video) 

2. Assistant 1 + 2: Apply downward countertraction on the patient's hip.

3. Operator: Stand on the patient’s affected side next to knee.

4. Operator: Place arm under the affected side’s knee and grasp the opposite knee.

5. Operator: With the other hand, grasp the near ankle and apply downward force to flex the knee.

6. Operator: Keep traction maintained with arm under knee.

7. Operator: Apply internal + external rotation with the hand on the ankle.

8. Post reduction, perform a neurovascular exam and place a knee immobilizer.

Captain Morgan Technique

Time: 20 mins
Personnel Required:
3
Equipment Required:
1. adequate analgesia 
2. If adding procedural sedation, end tidal CO2 + monitor
3. 2 bedsheets

Steps: 

1. Assistant 1 + 2: Place bedsheets over the patients hips and cross it under the bed like a belt. (not shown in video) 

2. Assistant 1 + 2: Apply downward countertraction on the patient's hip.

3. Operator: Stand on affected side, flex hip and knee to 90 degrees.

4. Operator: Place foot on bed and your knee under the patient’s knee.

5. Operator: Grasp ankle and apply downward traction while planter flexing upward against the patient’s knee.

6. Operator: Apply internal/external rotation and mild abduction/adduction as needed.

7. Post reduction, perform a neurovascular exam and place a knee immobilizer.

Allis Technique

Time: 20 mins
Personnel Required:
3
Equipment Required:
1. adequate analgesia 
2. If adding procedural sedation, end tidal CO2 + monitor
3. 2 bedsheets

Steps: 

1. Assistant 1 + 2: Place bedsheets over the patients hips and cross it under the bed like a belt. (not shown in video) 

2. Assistant 1 + 2: Apply downward countertraction on the patient's hip.

3. Operator: Stand on the bed on the affected side, grasp the proximal thigh, flex knee 90 degrees 

4. Operator: Apply axial traction while flexing the hip 

5. Operator: Apply internal/external rotation to the hip as needed 

6. Post reduction, perform a neurovascular exam and place a knee immobilizer.