Captain Morgan Technique for Reducing a Dislocated Hip

I really enjoy learning new techniques for medical procedures, because when one technique isn’t successful, it’s nice to know other ways to do things. I’m particularly pleased when the discovery and description of a new technique comes from one of my former students or residents. Such is the case the “Captain Morgan Technique” for reducing a dislocated hip, which is described in the December 2011 issue of Annals of Emergency Medicine (volume 58, number 6, page 536) by Dr. Gregory Hendey and his physician assistant associate Arturo Avila.

The standard technique that is taught to reduce a dislocated hip, in which the head of the femur has become dislodged from the hip socket (acetabulum) within the pelvis, involves bending (flexing) the victim’s hip and knee to 90 degrees, then lifting the leg while the victim (and pelvis) is somehow held down on a firm surface (such as the ground) while on his or her back. Reducing a hip usually requires a fair amount of strength and force, such that someone who is standing over and straddling the victim applies traction.

Using the image of Captain Morgan portrayed in advertisements (which is a pirate standing on a keg), the authors found that an excellent variation of the above method was to strap the victim on his or her back to a backboard, then flex the hip and knee as described. Then, instead of straddling the victim and attempting to use the rescuer’s arms to pull the head of the femur back into place, the rescuer simply steps directly underneath the flexed hip and knee by putting one foot on the board, and then places the rescuer’s knee directly underneath the highest part of the victim’s calf where it enters the back of the knee. Once in position, the rescuer can lift the injured persons dislocated hip toward the ceiling by simply stepping up on toes and using the calf muscle for power. If the hip doesn’t pop into place easily, the rescuer can manipulate the leg by holding the ankle and rotating the lower leg in and out, and/or rocking the upper leg side to side. Sometimes this provides the angle necessary for the head of the femur (the “ball” of the ball-and-socket) to move back into position, which often occurs with a “clunk” that can be felt and observed.

I’m eager to attempt this new technique, although it means that I will be treating some unfortunate person who has suffered a dislocated hip. That’s the way it is when health care professionals need to learn new techniques.