The Journal of Emergency Medicine, Vol. -, No. -, pp.

1–9, 2017
Ó 2017 Elsevier Inc. All rights reserved.
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https://doi.org/10.1016/j.jemermed.2017.12.002

Techniques
and Procedures

HIP DISLOCATIONS IN THE EMERGENCY DEPARTMENT: A REVIEW OF

REDUCTION TECHNIQUES

Michael Gottlieb, MD
Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
Corresponding Address: Michael Gottlieb, MD, 1750 West Harrison Street, Suite 108 Kellogg, Chicago, IL 60612

, Abstract—Background: Hip dislocations are a common most commonly after motor vehicle collisions (4). In
presentation in the Emergency Department (ED) and addition, reports have suggested that approximately 7%
require urgent reduction to reduce the risk of avascular ne- of all total hip replacements sustain a subsequent disloca-
crosis. Over 90% of all dislocations can successfully be tion (7).
reduced in the ED and there is evidence that cases awaiting
Reduction of a hip dislocation is often more chal-
operative reduction result in significant delays. Discussion:
lenging than dislocations of other locations, with most pa-
While there is limited data comparing specific techniques,
the individual success rates of most maneuvers range from tients requiring procedural sedation to facilitate the
60-90%. Additionally, each technique has distinct advan- reduction (8,9). Experts recommend up to 3 attempts at
tages and limitations associated with its use. Conclusions: closed reduction before considering operative reduction
It is important for Emergency Physicians to be familiar (4). However, approximately 10% of all hip dislocations
with several different reduction techniques in case the initial may be irreducible in the ED setting, requiring operative
reduction attempt is unsuccessful or patient characteristics reduction under general anesthesia (10). Importantly, dis-
limit the use of certain maneuvers. This article reviews a located hips are at significant risk of avascular necrosis
number of reduction techniques for hip dislocations, varia- and operative delays may be substantial, with 1 study
tions on these techniques, and advantages and disadvantages demonstrating a mean time delay of 10.9 hours among
for each approach. Ó 2017 Elsevier Inc. All rights
cases requiring general anesthesia (2,4,8,11). Therefore,
reserved.
it is essential for emergency physicians to be familiar
, Keywords—dislocation; hip; reduction; relocation with multiple techniques when performing reductions
of hip dislocations, especially if the first technique is
unsuccessful. This review is intended to describe
INTRODUCTION several different reduction maneuvers, variations on
these techniques, and advantages and disadvantages for
Hip dislocations are a common emergency department each approach (Table 1).
(ED) presentation, with studies suggesting an increasing
incidence in North America (1–3). The hip joint is a
ball-and-socket joint that is supported by multiple strong DISCUSSION
capsular ligaments (4–6). However, these ligaments may Allis Technique
get disrupted when a strong force is applied to the femur,
The Allis technique is a well-known approach that is still
Reprints are not available from the authors. frequently performed in many EDs. This technique was

RECEIVED: 20 September 2017; FINAL SUBMISSION RECEIVED: 3 November 2017;

ACCEPTED: 1 December 2017

1
2 Michael Gottlieb

Table 1. Review of Techniques for Hip Dislocation

Name Technique Advantages Disadvantages

Allis Provider grasps affected leg with Well-established Risk of falls and lower back injury
both knee and hip flexed to 90 to the provider
applying traction toward the
ceiling
Bigelow Provider grasps affected leg with This technique is no longer Risk of falls and lower back injury
both knee and hip flexed to 90 , recommended to the provider. Increased risk
applying in-line traction while of femoral neck fractures
abducting, externally rotating,
and extending the leg
East Baltimore lift Two providers place their arms Strong, controlled upward force Multiple providers are needed
underneath the affected knee and ability to internally and
with their knees bent and their externally rotate the hip
hands on each other’s
shoulders. Providers slowly
stand up while countertraction
is applied to the patient’s ankle
Tulsa/Rochester/Whistler Provider places the arm Requires only 1 provider Less upward force is possible.
underneath the affected knee Potential injury to the provider’s
with the provider’s palm on the forearm
flexed, unaffected knee. Using
the forearm as a fulcrum, the
provider applies downward
pressure on the ankle, while
internally and externally
rotating the hip
Flexion adduction One provider flexes and Allows for a controlled, steady Limited data on efficacy
maximally adducts the affected reduction attempt
hip, while the second provider
applies manual pressure on the
femoral head
Foot fulcrum Provider places patient’s foot Requires only 1 provider and Potential injury to provider’s back
against his or her inner ankle allows for a controlled, steady and patient’s sciatic nerve if
and places provider’s outer foot reduction attempt incorrectly performed. Risk of
against the patient’s femoral fall injury
head. Provider grasps patient’s
flexed knee and leans
backward
Howard Provider grasps affected leg with Allows for a slow, controlled Multiple providers are needed.
both knee and hip flexed to 90 , reduction attempt Limited data on efficacy
applying in-line traction, while a
second provider applies lateral
traction
Lateral traction Provider grasps affected leg in Valuable technique when the Multiple providers are needed.
extension and applies in-line patient is unable to flex the Limited data on efficacy
traction, while a second affected hip
provider applies lateral traction
Lefkowitz Provider places his or her knee Requires only one provider and Potential to injure patient’s knee
underneath the affected leg allows for a controlled, steady ligaments. Difficult to provide
with both knee and hip flexed to reduction attempt significant force for the
90 . Provider applies a reduction
downward force on the
patient’s lower leg, using the
knee as a fulcrum
Captain Morgan Provider places his or her knee Requires only 1 provider and May be more difficult in patients
underneath the affected leg allows for a controlled, steady with longer legs
with both knee and hip flexed to reduction attempt
90 . Provider plantarflexes
ankle to facilitate the reduction
PGI Provider gradually flexes knee to Allows for a controlled, steady Limited data, but appears
120 of flexion, then abducts to reduction attempt and does not promising
45 , and finally externally require significant force
rotates until the hip reduces
Piggyback/rocket launcher Provider places patient’s flexed Requires only 1 provider and Excess pressure on the lower leg
knee over his or her shoulder allows for a controlled, steady can injure the knee ligaments
and rises to a standing position reduction attempt

(Continued )
Hip Dislocations in the ED 3

Table 1. Continued

Name Technique Advantages Disadvantages

Skoff Patient is placed in left lateral Allows for a controlled, steady Multiple providers are needed.
decubitus with the leg in 100 of reduction attempt May be difficulty to palpate the
hip flexion, 45 of internal greater tuberosity. Limited data
rotation, 45 of adduction, and on efficacy
the knee bent to 90 . In-line
traction is applied to the leg,
while another provider applies
pressure to the greater
tuberosity
Stimson Patient is placed prone with the Well-established. Uses gravity to Multiple providers are needed.
affected leg 90 past the end of facilitate the reduction Difficulty to monitor the patient
the gurney. Downward traction in the prone position. Potential
is applied by the provider using for the patient to fall off the
either the provider’s arm or the gurney
provider’s bent knee
Traction–countertraction Patient is placed in left lateral Allows for a controlled, steady Multiple providers are needed.
decubitus with the leg in 100 of reduction attempt. The use of Limited data on efficacy
hip flexion, 45 of internal bed sheets for traction allows
rotation, and 45 of adduction. the provider freedom to use his
One provider applies posterior or her hands to facilitate the
traction at the upper thigh, reduction
while a second provider applies
anterior traction at the lower leg

first described in 1895 and is performed with the patient Despite the relatively common use of this technique,
supine and the provider on top of the bed (12). The pro- there are several disadvantages with this approach. The
vider grasps the affected leg at the knee and flexes both use of primarily lower back muscles may not allow as
the hip and the knee to 90 (Figure 1) (12). The provider much force to be used for the reduction attempt. In addi-
then applies traction toward the ceiling until the hip is tion, the awkward position may place the provider at risk
reduced (12). An assistant or bed sheet may be used to sta- of lower back injury. Finally, if the provider performs the
bilize the patient to the bed during the reduction attempt. procedure while standing on the bed, there is also a signif-
Alternatively, the patient may be strapped into a back- icant risk of the provider falling off the bed. Alternatively,
board to provide countertraction and support. While the the procedure could be performed with the provider
original description involved no rotation at the hip joint, standing next to the bed, or by placing the patient on a
it is generally recommended to perform gentle internal backboard on the floor to reduce the risk of injury to
and external rotation to facilitate the reduction attempt. the provider (Figure 2).
This technique has been suggested to be effective in
approximately 60% of reduction attempts (8,13).

Figure 2. Allis technique performed from a standing position

Figure 1. Traditional Allis technique. at the bedside.
4 Michael Gottlieb

Bigelow Technique Tulsa/Rochester/Whistler Technique

This is the oldest technique still used for hip reductions, A variation of the East Baltimore technique has been
dating back to 1870 (14). The Bigelow technique is described in the literature simultaneously as the Tulsa
similar to the Allis technique, in that the provider begins technique, Rochester technique, and Whistler technique
on the patient’s bed with both the knee and hip of the (13,20–22). With this technique, the patient flexes both
affected side flexed to 90 (14–16). The hip begins in hips and knees on the gurney. Then, the provider places
an adducted and internally rotated position (14–16). his or her arm underneath the patient’s affected knee
The provider then applies in line traction to the femur, and the provider’s palm on the unaffected knee
while gently abducting, externally rotating, and (Figure 4) (13,20–22). The physician places the other
extending the lower leg (14–16). Similar to the Allis hand on the patient’s affected ankle (13,20–22). Using
technique, an assistant or bed sheet is necessary to the proximal forearm as a fulcrum, the provider applies
stabilize the patient to the bed. This technique carries downward traction on the ankle, while internally and
similar risks as the Allis technique described above, externally rotating the hip (13,20–22). Nordt described
particularly the potential for lower back injuries and successful reduction in 13 consecutive patients, while
falling from the bed. In addition, this maneuver has Walden and Hamer demonstrated similar effectiveness
been suggested to result in higher rates of femoral neck between the Whistler and Allis techniques (62.5% vs.
fractures and, therefore, is not recommended at this 64.7%) with no significant complications in the
time (17,18). treatment group (13,21). The primary advantage of this
modified technique is the need for fewer providers to be
East Baltimore Lift Technique present to perform the reduction attempt. However, the
use of the provider’s arm as a fulcrum puts significant
This technique is performed on the supine patient and re- force onto the relatively smaller bones of the forearm
quires several providers or assistants to be involved. Two and carries some risk to the provider. In addition, this
providers stand on each side of the patient’s gurney with modification may not provide as much upward force as
their knees slightly bent and place their arms beneath the other techniques because the provider is relying on
patient’s knee with their hands on each other’s shoulders relatively weaker upper extremity muscles when
(19). Another assistant provides downward pressure on compared with lower extremity muscles.
the patient’s ankle while the first 2 providers provide an
upward force by rising to a standing position (19). Inter- Flexion Adduction Technique
nal and external rotation may be necessary to facilitate
the reduction. This may be modified by having one of The patient begins in the supine position. One provider
the providers apply downward traction on the ankle while stands on the opposite side of the patient and lifts the
using the contralateral arm to lift the patient’s leg contralateral, affected leg into flexion and maximal adduc-
(Figure 3). The advantage of the East Baltimore tech- tion, while proving inline traction with the femur (Figure 5)
nique is the ability to provide a strong upward force by (18,23). The other provider stabilizes the pelvis, while
using the stronger quadriceps and gluteal muscles of applying manual pressure to the head of the femur (23).
both providers. However, a distinct disadvantage of this
maneuver is the need for several providers to be present.

Figure 3. East Baltimore lift technique. Figure 4. Tulsa/Rochester/Whistler technique.

Hip Dislocations in the ED 5

Figure 5. Flexion adduction technique. Figure 6. Foot fulcrum technique.

This technique allows for a controlled, steady reduction applies lateral traction to the affected thigh, while the
attempt, reducing the risk of injury to the patient or pro- other provider applies inline traction of the femur
viders. Unfortunately, current data on the efficacy of this (Figure 7) (25). Often, the provider performing inline
maneuver are limited to procedural descriptions (18,23). traction will also perform gentle internal and external
rotation to facilitate the reduction (25). This technique
Foot Fulcrum Technique may be facilitated by having the assistant use a bed sheet
to apply the lateral traction. Unfortunately, there is mini-
With this maneuver, the patient lies supine on the bed and mal available evidence on the effectiveness of this tech-
the provider is seated on the bed at the patient’s feet (24). nique.
Before the reduction, the provider gently flexes the pa-
tient’s affected hip and knee as much as possible in order Lateral Traction Technique
to shift the femoral head into a more posterior position
(24). The provider places his or her inner foot against the This technique shares similarities with the Howard ma-
anterior aspect of the patient’s ankle and his or her outer neuver in that the patient is supine and lateral traction
foot on the posterolateral aspect of the patient’s hip, is applied to the midthigh by an assistant. However, as
palpating for the femoral head (24). The physician grasps opposed to the Howard technique, the provider applies
the patient’s flexed knee and leans backward, using the in- a longitudinal force along the length of the femur with
ner foot as a fulcrum, while using the outer foot to provide the leg extended at the knee (Figure 8) (21). Often, the
pressure against the femoral head (Figure 6) (24). This provider will need to perform internal rotation to facili-
may be facilitated by applying internal and external rota- tate the reduction (21). One advantage of this technique
tion. The original authors were able to successfully reduce
15 of 19 dislocations using this technique (24).
This technique may be advantageous in locations with
limited personnel, because only 1 provider is needed for
this technique. However, this technique poses several
risks to both the patient and provider. Similar to the Allis
and Bigelow techniques, the provider may injure his or
her back during the reduction and also has the potential
to fall from the bed (12,14). In addition, if the outer foot
pressure is not directed in the correct location, it is
possible to cause significant damage to the patient’s
sciatic nerve.

Howard Technique

For this technique, the patient is supine on the gurney the

affected knee and hip flexed to 90 (25). An assistant Figure 7. Howard technique.
6 Michael Gottlieb

Figure 8. Lateral traction technique. Figure 9. Lefkowitz technique.

is that it can be performed in patients who are unable to technique, the Captain Morgan maneuver reduces the risk
flex their hip—a limitation to most of the other described of back injury and does not require the provider to stand
techniques. Unfortunately, there are limited data on the on the patient’s bed. In addition, the Captain Morgan
effectiveness of this technique. technique allows the provider to combine calf and upper
extremity strength to facilitate the reduction, while
Lefkowitz Technique reducing the traction forces on the patient’s knee.

The Lefkowitz technique was first described in 1993 and PGI Technique
is performed with the patient supine on the stretcher. The
provider places his or her flexed knee under the patient’s The PGI technique, named after the Postgraduate Insti-
ipsilateral knee in the popliteal fossa (Figure 9) (26,27). tute of Medical Education and Research, is one of the
The provider holds the patient’s leg at the anterior thigh few reduction techniques that does not require traction
and ankle while an assistant stabilizes the patient on the femur (29). With this technique, the patient lies
(26,27). The provider applies a downward force on the in a supine position with the knee bent to 90 (29). The
patient’s lower leg, using the knee as a fulcrum to provider begins by gradually flexing the knee to 120 of
elevate the hip (26,27). Internal and external rotation flexion (29). Next, the provider abducts the knee to
may be used to facilitate the reduction attempt. This approximately 45 of abduction (29). Finally, the pro-
technique is advantageous because it reduces the risk of vider performs gentle external rotation until the hip re-
back injury and does not require the provider to stand duces (29). The authors do not recommend any traction
on the patient’s bed. However, by using the knee as a be used in this technique (29). In their 15-patient sample,
fulcrum, the provider has the potential to damage the closed reduction was successful in 93% of patients with
patient’s knee ligaments during the reduction attempt. the isolated reduction failure necessitating operative
reduction because of an intra-articular fracture fragment
Captain Morgan Technique (29). This technique has significant promise because of
the relative ease of reduction for the provider and
A modification of the Lefkowitz technique, referred to as decreased potential for iatrogenic injury.
the Captain Morgan maneuver, was described in 2011
(28). Differences with respect to this technique include Piggyback/Rocket Launcher Technique
the use of a backboard to stabilize the patient and a focus
on elevating at the knee rather than applying downward For the piggyback technique, the patient is placed in the
pressure on the ankle. With this approach, the provider supine position near the end of the gurney. The patient’s
will plantarflex his or her ankle and lift upward with his affected leg is flexed at the hip and the patient’s knee is
or her hand to elevate the patient’s leg and facilitate placed over the provider’s shoulder (Figure 10) (5,30).
reduction (28). The original study by Hendey and Avila Using the shoulder as a fulcrum, the provider applies a
reported a 92% success rate with the isolated reduction downward force on the patient’s ankle until the hip is
failure requiring open reduction because of an intra- reduced. A modification of this approach, referred to as
articular fracture fragment (28). Similar to the Lefkowitz the rocket launcher technique, involves the provider
Hip Dislocations in the ED 7

Figure 10. Piggyback/rocket launcher technique. Figure 11. Skoff technique.

rising to a standing position while applying external 90 past the end of the gurney. The provider flexes both
rotation and abduction to the hip joint (31). This tech- the hip and the knee to 90 while applying a downward
nique was able to successfully reduce 5 of 6 dislocations force on the lower leg with one arm (33,34). The
in a sample case series by Dan et al. (31). physician may use the other arm to internally and
This technique has the advantage of using the shoulder externally rotate the leg, while maintaining adduction
as a fulcrum, reducing the potential for provider injury until the hip reduces (Figure 12) (33,34). A
when compared with the Whistler technique. In addition, modification of this technique has been described,
the rocket launcher technique allows for a greater amount wherein the provider places his or her knee behind the
of force to be applied in a controlled setting by having the popliteal fossa and gently transfers the weight to the
provider use the much stronger quadriceps and gluteal bent knee, thereby allowing both hands to be free with
muscles. one stabilizing the patient and the other providing
internal and external rotation of the hip (Figure 13)
Skoff Technique (35,36).
One advantage of this technique is the beneficial effect
For this technique, the patient is placed in the left lateral of gravity by allowing the weight of the leg itself to assist
decubitus position with the affected leg facing upward with the reduction effort. In addition, the provider uses
(32). An assistant should position the leg in 100 of hip downward force, resulting in a lower risk of falls or low
flexion, 45 of internal rotation, and 45 of adduction, back injury. A disadvantage of this technique is the
with the knee bent to 90 (Figure 11) (32). The assistant requirement for prone positioning, which can make it
will provide lateral traction in line with the femur, while more difficult to assess the airway during procedural
the provider palpates for the deformity in the gluteal area
and pushes on the greater trochanter to realign the
femoral head with the acetabulum (32).
This maneuver is relatively simple to perform and of-
fers the advantage of allowing gravity to assist the reduc-
tion. However, it may be challenging to palpate the
greater tuberosity and defect among patients with a larger
body habitus or by less experienced providers. Unfortu-
nately, the current data on the effectiveness of this
approach are limited to a case report.

Stimson Technique

This is one of the oldest described techniques for hip

dislocation, dating back to 1883, when Lewis Stimson
first described it (33,34). For this technique, the patient
is placed prone on the gurney with the affected leg at Figure 12. Stimson technique.
8 Michael Gottlieb

Figure 13. Modified Stimson technique. Figure 14. Traction–countertraction technique.

sedation. In addition, the patient positioning often re- tler). As a result, one must tailor the attempt to the patient
quires a second provider to be present to help stabilize circumstances. Should the first attempt be unsuccessful,
the patient from falling from the cart. the provider is advised to attempt a different technique
on the subsequent reduction attempt. Therefore, it is
Traction–Countertraction Technique essential that emergency physicians be familiar with
several reduction techniques to ensure the best likelihood
The patient is placed in the left lateral decubitus position of successful reduction.
with the affect leg facing upward (37). An assistant posi-
tions the leg in 90 of hip flexion, 45 of internal rotation, Acknowledgments—The author would like to thank Kimbia
and 45 of adduction, similar to the Skoff technique (32). Arno, MD, Christine Binkley, MD, MPH, and Chase Socha,
Using bed sheets wrapped around the patient and pro- MD, MPH for their assistance with the accompanying figures.
viders, 1 provider applies anterior traction to the lower
leg, while the other provider applies posterior traction REFERENCES
to the upper thigh (Figure 14) (37). The closest provider
will palpate for the deformity in the gluteal area and 1. Clegg TE, Roberts CS, Greene JW, et al. Hip dislocations—epide-
push on the greater trochanter to realign the femoral miology, treatment, and outcomes. Injury 2010;41:329–34.
head with the acetabulum (37). 2. Foulk DM, Mullis BH. Hip dislocation: evaluation and manage-
ment. J Am Acad Orthop Surg 2010;18:199–209.
This technique offers similar advantages and disad- 3. Stein MJ, Kang C, Ball V. Emergency department evaluation and
vantages as the Skoff technique. In addition, the use of treatment of acute hip and thigh pain. Emerg Med Clin North Am
bed sheets to facilitate traction allows for freedom of 2015;33:327–43.
4. Tornetta P 3rd, Mostafavi HR. Hip dislocation: current treatment
the provider’s hands to focus on more direct reduction regimens. J Am Acad Orthop Surg 1997;5:27–36.
and stabilization efforts. Unfortunately, there are limited 5. Yang EC, Cornwall R. Initial treatment of traumatic hip dislocations
data on the effectiveness of this technique beyond anec- in the adult. Clin Orthop Relat Res 2000;377:24–31.
6. Beebe MJ, Bauer JM, Mir HR. Treatment of hip dislocations and
dotal experience. associated injuries: current state of care. Orthop Clin North Am
2016;47:527–49.
CONCLUSION 7. Alberton GM, High WA, Morrey BF. Dislocation after revision total
hip arthroplasty: an analysis of risk factors and treatment options. J
Bone Joint Surg Am 2002;84A:1788–92.
While the above techniques have been used for hip dislo- 8. Frymann SJ, Cumberbatch GL, Stearman AS. Reduction of dislo-
cations, none has been demonstrated to have superior ef- cated hip prosthesis in the emergency department using conscious
sedation: a prospective study. Emerg Med J 2005;22:807–9.
ficacy when compared with the others. Consequently, 9. Dela Cruz JE, Sullivan DN, Varboncouer E, et al. Comparison of
determining which technique should be used first often procedural sedation for the reduction of dislocated total hip arthro-
depends upon the patient and provider. For example, a pa- plasty. West J Emerg Med 2014;15:76–80.
10. Germann CA, Geyer DA, Perron AD. Closed reduction of prosthetic
tient that requires close airway monitoring should not be hip dislocation by emergency physicians. Am J Emerg Med 2005;
placed prone (e.g., Stimson), while a patient with contra- 23:800–5.
lateral extremity injury will not tolerate the lateral posi- 11. Hougaard K, Thomsen PB. Traumatic posterior dislocation of the
hip—prognostic factors influencing the incidence of avascular ne-
tion (e.g., Skoff, traction–countertraction) or the use of crosis of the femoral head. Arch Orthop Trauma Surg 1986;106:
the other extremity to facilitate the reduction (e.g., Whis- 32–5.
Hip Dislocations in the ED 9

12. Allis OH. The hip. Philadelphia: Dorman; 1895. 25. Howard CB. A gentle method of reducing traumatic dislocation of
13. Walden PD, Hamer JR. Whistler technique used to reduce traumatic the hip. Injury 1992;23:481–2.
dislocation of the hip in the emergency department setting. J Emerg 26. Lefkowitz M. A new method for reduction of hip dislocations. Or-
Med 1999;17:441–4. thop Rev 1993;22:253–6.
14. Bigelow HJ. Luxations of the hip joint. Boston Med Surg J 1870;5: 27. Bergman NJ. Reduction of posterior dislocation of the hip. Trop
65–7. Doct 1994;24:134–5.
15. Bigelow HJ. On the dislocated hip. Lancet 1878;1:860–2. 28. Hendey GW, Avila A. The Captain Morgan technique for the reduc-
16. Bigelow HJ. On the dislocated hip. Lancet 1878;1:894–5. tion of the dislocated hip. Ann Emerg Med 2011;58:536–40.
17. Pallia CS, Scott RE, Chao DJ. Traumatic hip dislocation in athletes. 29. Sharma S, Kumar V, Dhillon MS. A new technique for closed reduc-
Curr Sports Med Rep 2002;1:338–45. tion of traumatic posterior dislocations of the hip: the ‘PGI tech-
18. McMurtry IA, Quaile A. Closed reduction of the traumatically dis- nique’. Hip Int 2014;24:394–8.
located hip: a new technique. Injury 2001;32:162–4. 30. Marya SK, Samuel AW. Piggy back technique for relocation of pos-
19. Schafer SJ, Anglen JO. The East Baltimore Lift: a simple and effec- terior dislocation of the hip. Injury 1994;25:483–4.
tive method for reduction of posterior hip dislocations. J Orthop 31. Dan M, Phillips A, Simonian M, et al. Rocket launcher: a novel
Trauma 1999;13:56–7. reduction technique for posterior hip dislocations and review of cur-
20. Vosburgh CL, Vosburgh JB. Closed reduction for total hip arthro- rent literature. Emerg Med Australas 2015;27:192–5.
plasty dislocation. The Tulsa technique. J Arthroplasty 1995;10: 32. Skoff HD. Posterior hip dislocation, a new technique for reduction.
693–4. Orthop Rev 1986;15:405–9.
21. Nordt WE 3rd. Maneuvers for reducing dislocated hips. A new tech- 33. Stimson LA. A treatise on fractures and dislocations. Philadelphia:
nique and a literature review. Clin Orthop Relat Res 1999;360: Henry C. Lea’s Son; 1883.
260–4. 34. Stimson LA. Five cases of dislocation of the hip. NY Med J 1889;
22. Stefanich RJ. Closed reduction of posterior hip dislocation: the Ro- 50:118–21.
chester method. Am J Orthop (Belle Mead NJ) 1999;28:64–5. 35. Shi MQ. A new method of reduction of the hip joint. Chin J Surg
23. Bassi JL, Ahuja SC, Singh H. A flexion adduction method for the 1983;4:203.
reduction of posterior dislocation of the hip. J Bone Joint Surg Br 36. Herwig-Kempers A, Veraart BE. Reduction of posterior dislocation
1992;74:157–8. of the hip in the prone position. J Bone Joint Surg Br 1993;75:328.
24. Yin TC, Wang JW, Lao ML, et al. A simple technique for reducing 37. Dahners LE, Hundley JD. Reduction of posterior hip dislocations in
posterior hip dislocation: the foot-fulcrum manoeuvre. Injury 2010; the lateral position using traction-countertraction: safer for the sur-
41:665–7. geon? J Orthop Trauma 1999;13:373–4.