Letter to the Editor

Abstract

Dear Sir: The hip is a large ball and socket joint which is surrounded by massive muscles and ligaments. Dislocations of this joint occur most commonly in the young as a result of high energy trauma. 1,3 Reduction of such a dislocated hip necessitates a major force. A new technique for reduction of dislocated hips was described by Nordt. 2 In his series 13 hips were reduced by his method. Twelve had dislocated hip prostheses and only one was traumatic. In the last year we treated six patients (five men aged 17 to 42 years and one 70-year-old woman) with traumatic dislocation of the hip. In our institution, total hip replacement or hip hemiarthroplasty is done using the direct lateral approach; hence, posterior dislocations are rare. We used the maneuver as described by Nordt for the six patients with traumatic dislocation of the hip in the emergency room and all patients were sedated with Midazolam HCl 4 to 8 mg. In all patients reduction was performed successfully in the first attempt. One patient (a 70-year-old woman with a femoral head fracture), who had recurrent dislocations of the hip despite skin traction of the limb, had the hip relocated successfully four times without analgesia, using the maneuver described by Nordt, until she eventually underwent total hip replacement. Although most of the patients were young and active men with strong muscles, all surgeons who used this method (two senior surgeons and three residents) found it much easier to perform than other traditional methods for reduction of dislocated hips. We recommend and encourage other orthopaedic surgeons to use this maneuver for reducing dislocated hips. Shay Shabat MD B. Kish MD A. Stern MD M. Nyska MD