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Our old friend Captain Morgan (the rum pirate) may now be able to assist us during a shift, not just afterwards.
http://www.inquisitr.com/wp-content/2011/08/captain-morgans-pirate-ship-satisfaction-panama.jpg
In a small case series in last months Annals of Emergency Medicine, a new reduction maneuver was described as an alternative to the traditional Aliis's maneuver.
The maneuver is named after the pirate spokesperson for the similarities in body positioning.
The patient is placed supine on a stretcher. The pelvis is fixed to a backboard with a strap. The patient's hip and knee are flexed to 90 degrees. The physician places one foot on the back board with the same knee behind the patient's knee. By holding the patient's ankle down, the patient's knee is kept in flexion. The physician then lifts his/her calf, thereby applying an upward force to the hip while gently rotating the lower leg from side to side.
http://www.youtube.com/watch?v=l07K-mO2X84
with a slight variation
http://www.youtube.com/watch?v=sGQZaqB48rw
The success rate was 12 of 13 cases. The single failure occurred in a patient with an acetabular fracture with an intra-articular fragment requiring open reduction. There were no described neurovascular complications or injuries to the knee. The technique limits the physician's risk of back strain and of falling from the stretcher.
References
The Captain Morgan technique for the reduction of the dislocated hip.
Hendey GW, Avila A.
Ann Emerg Med. 2011 Dec;58(6):536-40. Epub 2011 Aug 12.