Closed reduction of traumatic bilateral anterior hip dislocations with sedation: a case report and review of the literature

Abstract

A rare case of bilateral anterior hip dislocation reduced under sedation was reported in this study. A 47-year-old man was knocked down by a car and sustained bilateral anterior hip dislocation which was reduced successfully with sedation using titrated dose of intravenous Midazolam in combination with Pethidine. A modified Lefkowitz maneuver using the manipulator's thigh as a fulcrum was used. Patient started weight bearing in the second month after injury and was walking without any hip pain at the twenty-fourth month follow-up. Thirteen case reports describing bilateral anterior hip dislocations were found while reviewing the literature and it was noticed that only one author had reported the usage of intravenous sedation (Propofol) for the reduction procedure. However, no author reported the use of Lefkowitz maneuver for this purpose. Consequently, reduction of a bilateral anterior hip dislocation is possible with sedation using a modified Lefkowitz maneuver.

Prognostic and therapeutic interest of a new classification in inferior hip dislocation: a systematic review of the literature

“…The main reduction manoeuvers identified were those usually used for the reduction of posterior dislocations by placing the hip in traction (14.6%), including the Allis manoeuver ( n = 10), 89 the Bigelow manoeuver ( n = 2), 91 the Howard manoeuver ( n = 1), 28 and finally the Lefkowitz manoeuver ( n = 2). 39…”

“…The main reduction manoeuvers identified were those usually used for the reduction of posterior dislocations by placing the hip in traction (14.6%), including the Allis manoeuver (n = 10), 89 the Bigelow manoeuver (n = 2), 91 the Howard manoeuver (n = 1), 28 and finally the Lefkowitz manoeuver (n = 2). 39 9 other cases (8.7%) were reduced by lateral traction associated with medial pressure to recentre the head. Traction alone constituted 5.8% (n = 6) of the procedures, including 1 case on an orthopaedic table.…”

Closed reduction of the traumatic posterior-dislocation of hip joint using a novel sitting technique

“…The incidence of AVN is closely related to the interval between the injury and the reduction. [ 4 ] Delayed reduction has been shown to increase the risk of AVN, [ 5 , 6 ] which is more than 50% in patients who receive reduction 6 hours after the injury; in contrast, there is only 5% in patients who are reduced within 6 hours. [ 7 ] Therefore, the initial treatment is critical to this injury.…”