Episode 11 - Managing Dislocations of the Hip, Knee, and Ankle in the Emergency Department

Managing traumatic dislocations of the hip, knee, and ankle requires rapid assessment and precise reduction techniques to mitigate long-term morbidity. Hip dislocations, predominantly posterior, necessitate reduction within six hours to minimize the risk of avascular necrosis, with various maneuvers like the Captain Morgan or East Baltimore Lift proving effective. Knee dislocations demand heightened vigilance for popliteal artery injury, where an ankle-brachial index exceeding 0.9 serves as a critical diagnostic threshold for vascular integrity. Ankle dislocations frequently present as open injuries with associated fractures, requiring immediate stabilization and urgent orthopedic consultation. Across all joint injuries, early neurovascular evaluation and timely reduction remain the cornerstones of emergency management, as delays significantly correlate with increased amputation rates and permanent joint dysfunction.