Bigelow's Maneuver: for Posterior Hip Dislocation

- See: 
- Closed Reduction 
- Gravity Method of Stimson

- Discussion: 
- pt lies supine, & assistant applies countertraction by downward pressure on the ASIS;  

- surgeon grasps affected limb at ankle w/ one hand, places opposite forearm behind the knee, and applies longitudinal traction in line of deformity; 
- adducted & internally rotated thigh is flexed > 90 deg on abdomen; 
- this relaxes the Y ligament and allows the surgeon to bring the femoral head near the posteroinferior rim of the acetabulum 
- while traction is maintained, femoral head is levered into acetabulum by abduction, external rotation, and extension of hip. 
- after reduction: 
- avoid: flexion, internal rotation, and adduction; - traction is maintained until pt. is pain free (2 wks) 

Reduction of posterior dislocation of the hip in the prone position.  

- Reverse Bigelow's Maneuver:
- position of hip is partial flexion and abduction;

- two methods of reduction: - first is lifting method, in which firm jerk is applied to flexed thigh; 
- this often results in reduction except in pubic dislocations; 
- if lifting method fails, traction is applied in the line of deformity; 
- hip is then adducted, sharply internally rotated, and extended; 
- one must be careful using this technique, since sharp internal rotation can result in frx of the femoral neck

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, September 6, 2012 11:22 am