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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) 

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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