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Hip Relocation

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The Primary Exam
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I remember the days when we had to reduce hips in the emergency department and I used to have to jump on the bed. Stand there and pull up on the hip with the knee at right angles. In fact I remember, many years ago, working in a small emergency department with one doctor and one nurse overnight because admin refused to put on more staff, and having to give sedation and asking the nurse to hold the bag, whilst I jumped on the bed and pulled the hip back in.

Now that I’m older, I can’t do this any more. But, maybe wisdom allows us to use a different approach. I recently saw this used in the US and loved it.

Remember that the longer the hip has been out, the harder it is to put in. The exception to the rule is the hip that has come out 20 times in the last 2 months. The problem with that hip, is keeping it in. For all other, make sure the patient is well sedated.

So here is a new technique for putting in hips. I call it the ‘Under/Over lift’. Watch how easily it goes in in this video.

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5 Comments

  1. pat naidoo on 07/07/2011 at 7:43 am

    after 30 yrs i was still using the jump on the bed technique.
    You made it look so simple and it really is after i tried the technique.
    Thanks for the tip and keep up the good work. Cheers Pat

  2. Andrew Walker on 07/07/2011 at 9:49 am

    I like it.

  3. Hamid Golshan on 12/07/2011 at 10:04 am

    Hi peter ,

    Too easy to believe!

    What is this patient sedated with , has she got sux on the board.

    My experience with relocating these patients in ED without Sux , is often incomplete relaxation , leading to aquiriung low back injury and pain at night when you go home .

    Regards,

    Hamid Golshan

    • admin on 12/07/2011 at 10:29 am

      Hi Hamid
      The patient only has ‘propofol’ on board, no muscle relaxants. The secret in hips, is to get them deep with the ‘propofol’.

  4. hamid golshan on 19/08/2011 at 12:30 am

    I applied this new method to a 70 year old with dislocated hip prosthesis tonight , and it worked well . Easy method ,Safe to the patient , operator and assistant.

    Hamid Golshan

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