- 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)
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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