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Assistant applies downward pressure to Pelvis (at ASIS).Patient supine with knee flexed to 90 degrees.Gentle extension and external rotation will ultimately relocate the hip into the acetabulum.Gently rotate the hip internally and externally until hip reduction is achieved.Adduct the hip and internally rotate the femur.Hip is slightly flexed and then gradually flexed more to 90 degrees.Apply longitudinal traction in-line with femur.Examiner stands on bed above the patient.Assistant stabilizes Pelvis, and lateral traction to inner thigh.Patient supine with affected knee flexed.Regional Anesthesia may be considered but may not offer adequate hip relaxation.Difficult reduction is often due to inadequate sedation.Deeper Procedural Sedation is required to allow for maximal hip relaxation.Typically unsuccessful unless performed immediately, as large hip Muscles are difficult to overpower.Closed reduction has been performed on field immediately after Hip Dislocation.Indicated for Fracture, failed reduction.Most hip reductions are performed in the Emergency Department under Procedural Sedation.Identify Fracture sites along the ipsilateral leg.Instability may suggest unstable Pelvic Fracture.Evaluate for deformity, swelling, instability or significant tenderness.Perform passive and active range of motion if patient able.Evaluate for deformity, swelling, Ecchymosis.Posterior tibial pulse and dorsalis pedis pulse.Lateral and medial foot and leg Sensation.Standard Musculoskeletal Trauma Evaluation.Motor Vehicle Accidents with Hip Dislocation are associated with other injuries in two thirds of patients.
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Start with a General Trauma Evaluation with Secondary Survey.