1070. What % patients with hip dislocation have other serious injuries? / What % hip dislocations are posterior? What is the usual mechanism? / Mechanism of anterior dislocation? / Fractures assoc with hip dislocation / Presenting posture of posterior hip dislocation

I thank Drs. Almazroua and Vilke for their comments on the Captain Morgan technique for reducing a dislocated hip. They have correctly pointed out that the knee should not be used as a fulcrum, with the main force coming from downward pressure on the patient’s ankle. Instead, the main force should be an upward or lifting force generated by one’s gastrocnemius and soleus muscles. Although I have not personally encountered a complication as described by the authors, I agree with their concern that using the knee as a fulcrum could impart a great deal of force to the patient’s knee, risking ligamentous injury. As we did describe in our article, this is one of the primary ways in which our method differs from the original report by Lefkowitz, which advocated “downward pressure applied to the patient’s ankle.”¹ Again, I thank you for emphasizing this important point, and may the Captain go with you. [G Hendey]