Trick of the Trade: Hip dislocation Part II

As a followup to the blog on the Captain Morgan technique for hip dislocations, I’d like to throw out another similar technique that also does NOT involve climbing up on the gurney.

Whistler Technique

This technique was developed in the ski town of Whistler, B.C., where the majority of their hip dislocations resulted from either a skiing or snowboarding accident. The technique applies the same principles as the Captain Morgan technique but uses the provider’s forearm instead of their knee in the popliteal fossa.

1. The patient lies supine on the gurney.
2. Unaffected leg is flexed with an assistant stabilizing the leg. The assistant can also help stabilize the pelvis.
3. Provider’s forearm is placed under the affected leg in the popliteal fossa then grasps the knee of the unaffected leg.
4. Provider’s other hand grasps the lower leg of the affected leg, usually around the ankle.
5. The dislocated hip should be flexed to 90 degrees.
6. The provider’s forearm is the fulcrum and the affected lower leg is the lever.
7. When pulling down on the lower leg, it flexes the knee thus pulling traction along the femur.
8. You can also add some internal/external rotation to facilitate the reduction.

Is it the definitive hip dislocation reduction technique? No…but something else to add to your bag of tricks when the usual doesn’t work.

I’ve used the Whistler technique multiple times with success. The few times it hasn’t worked, I’ve converted to the Captain Morgan technique. No more gymnastics on the gurney!!!

Has anyone else tried it?

Reference
Walden PD, Hamer JR. Whistler technique used to reduce traumatic hip dislocation of the hip in the emergency department setting. J Emerg Med.1999 May-June;17(3):441-4. Pubmed

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