Orthopaedic trauma · London
Closed reduction of hip dislocation — an orthopaedic emergency.
A dislocated hip needs to be reduced within hours, not days. Under general anaesthetic, by a consultant orthopaedic trauma surgeon, with a CT afterwards to check the joint is truly back together.
Why patients choose us
- 01
A consultant orthopaedic trauma surgeon, on-call
A dislocated hip is an emergency. A named orthopaedic trauma consultant is available for reduction — not a passing junior in a busy department.
- 02
Anaesthetist-led theatre reduction
Proper muscle relaxation under general anaesthetic, in a theatre — not a corridor sedation attempt that fails and worsens the injury.
- 03
Post-reduction CT and follow-through
CT after reduction to check joint congruity and loose bodies, plus the aftercare plan — hip precautions, weight-bearing and DVT prophylaxis.
Indicative pricing
What the hip dislocation pathway costs in London.
The reduction itself belongs on the NHS emergency pathway. The private imaging, follow-up and any elective revision surgery are what we quote for.
In short
Emergency reduction: NHS pathway. Post-reduction CT and follow-up: £500–£900.
| Step | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Emergency closed reduction under GA | NHS emergency pathway | 30–60 min theatre | Same admission |
| AP pelvis and lateral hip X-ray | £150–£300 | 15 min | Same visit |
| Post-reduction CT hip / pelvis | £500–£900 | 20 min | Same day |
| MRI hip (avascular necrosis screen) | £400–£800 | 30 min | 24–48 h |
| Orthopaedic consultant follow-up | £250–£450 | 30 min | Within 1–2 weeks |
| Prosthetic hip revision (if recurrent) | Quote on request | Inpatient | Scheduled |
Prices vary by clinic and by the imaging and consultant chosen. If a dislocation happens while you are with us in a private setting, the pathway is discussed in detail — but a fresh emergency belongs in A&E.
The problem
The right surgeon, the right anaesthetic, the right timing.
A dislocated hip is one of the few injuries where the difference between a good and a poor outcome is measured in minutes. The three things worth getting right are the surgeon, the anaesthetic and the clock.
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Reduce it inside 6 hours
Under 60 minutes if at all possible. Every hour a dislocated hip stays out raises the avascular necrosis rate.
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Anaesthetist-led theatre
General anaesthetic for muscle relaxation — the reduction fails without it and cartilage gets damaged trying.
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CT after every reduction
A concentric-looking X-ray is not enough. CT catches the loose bodies and small rim fractures that change management.
The emergency pathway
From arrival to reduction — what happens, in order.
The steps a well-run orthopaedic trauma department follows from A&E arrival through to discharge.
Phase 1 · Before reduction
Assessment, imaging, planning
Phase 2 · Reduction
Theatre, GA, manoeuvre, CT
Phase 3 · After
Precautions and follow-up
- 01
Before
Emergency call in
A suspected hip dislocation is an emergency. Call 999 or go to A&E — the leg is often shortened, adducted and internally rotated (posterior), or abducted and externally rotated (anterior).
- 02
Before
Rapid imaging
AP pelvis and lateral hip X-rays to confirm the dislocation and screen for acetabular or femoral head fracture. CT if a fracture-dislocation is suspected.
- 03
Before
Neurovascular check
Sciatic nerve function (foot dorsiflexion, sensation) is documented before any manipulation. Distal pulses and skin perfusion are checked.
- 04
Reduction
Transfer to theatre
The reduction is performed in theatre under general anaesthetic for proper muscle relaxation — not attempted in the emergency bay unless theatre is truly unavailable.
- 05
Reduction
Closed reduction manoeuvre
Allis, Bigelow, Stimson or Captain Morgan technique — chosen by the surgeon. Ideally within 60 minutes and always under 6 hours to reduce avascular necrosis risk.
- 06
Reduction
Post-reduction imaging
Repeat X-ray to confirm concentric reduction, then CT to assess joint congruity, intra-articular loose bodies and any occult acetabular or femoral head fracture.
- 07
After
Recovery and rehabilitation
Hip precautions, protected weight-bearing, DVT prophylaxis and outpatient orthopaedic follow-up. MRI at six weeks if avascular necrosis is a concern.
Target time from arrival to reduction: under 60 minutes. Absolute upper limit: 6 hours.
When it applies
The dislocations we reduce closed — and the ones we don’t.
The commonest patterns, the associated injuries to look for, and the red flag that means stop trying closed and go to open reduction.
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Posterior hip dislocation
More than 90% of native hip dislocations. Classic dashboard injury from a road traffic collision — leg shortened, adducted and internally rotated.
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Anterior hip dislocation
Uncommon (about 10%). Leg held abducted and externally rotated. Higher risk of femoral head and femoral nerve injury.
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Fracture-dislocation
Dislocation with an acetabular rim, wall or femoral head fracture (Pipkin injury). Needs urgent CT and often surgical fixation after reduction.
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Sciatic nerve palsy
Foot drop or altered sensation on the sole after a posterior dislocation — documented before and after reduction, and a reason for urgent orthopaedic review.
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Prosthetic hip dislocation
A dislocated total hip replacement. Often reducible closed under sedation or GA, but recurrent dislocation usually needs revision or abduction bracing.
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Delayed presentation
A hip that has been dislocated more than 12 hours has a much higher avascular necrosis rate — reduction is still attempted but open reduction may be needed.
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High-energy trauma
MVC dashboard injury, fall from height, or sports contact injury. Look for associated knee, femur, spine and pelvic ring injuries.
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Red flag: irreducible hip
A hip that will not reduce closed under GA after two or three attempts is a surgical emergency — open reduction in theatre, do not keep pulling.
Techniques
More than one way to reduce a hip.
The named manoeuvres and when each one is used — plus the situations that stop being a closed reduction and become open surgery.
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Allis manoeuvre
Patient supine. Surgeon stands over the patient, flexes the hip and knee to 90 degrees, and applies axial in-line traction while an assistant stabilises the pelvis.
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Bigelow manoeuvre
Patient supine. Traction with flexion, adduction and internal rotation, then a circumduction sweep into extension, abduction and external rotation. Less used now.
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Stimson technique
Patient prone with the affected leg hanging off the end of the trolley. Gravity plus gentle downward pressure behind the knee reduces the hip — kind on the soft tissues.
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Captain Morgan technique
Patient supine, pelvis strapped down. The surgeon places one knee under the patient’s flexed knee and levers upward — good ergonomics, less tiring than Allis.
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Rocket / Whistler technique
Variations that use the surgeon’s forearm as a lever behind the flexed knee. Chosen by preference and by patient body habitus.
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Open reduction
If closed reduction fails after two or three attempts, or the hip is irreducible because of interposed soft tissue or bone, formal open reduction in theatre is needed.
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Prosthetic hip reduction
A dislocated total hip replacement is usually reducible closed under sedation or GA. Recurrent dislocations need revision surgery or an abduction brace.
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Post-reduction CT
Not optional. CT after every hip reduction to check joint congruity, exclude intra-articular loose bodies, and identify occult acetabular or femoral head fractures.
Our vetted London network
A small panel of orthopaedic trauma surgeons, we picked them.
Consultant orthopaedic surgeons across central London for follow-up, imaging review and any revision surgery. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant orthopaedic trauma surgeons, not trainees, for native hip reductions
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General anaesthetic for muscle relaxation — not corridor sedation
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Post-reduction CT on every case, not just clinical satisfaction
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Clear plan for hip precautions, weight-bearing and DVT prophylaxis on discharge
Safety and complications
The risks worth naming — honestly.
A dislocated hip is a significant injury. The reduction itself is usually straightforward under GA — the risks worth knowing about are avascular necrosis, sciatic nerve palsy and missed associated injury.
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Time-critical — reduce within 6 hours
The risk of avascular necrosis of the femoral head rises sharply after 6 hours. The target is under 60 minutes from arrival to reduction where possible.
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General anaesthetic, not conscious sedation
Proper muscle relaxation is what makes closed reduction possible. Trying without it damages cartilage, breaks stitches and often fails.
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Avascular necrosis of the femoral head
The commonest long-term complication (up to 15–20% overall, higher with delayed reduction). MRI at six weeks to three months if suspected.
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Sciatic nerve palsy
Occurs in around 10% of posterior dislocations. Foot drop and altered sole sensation — recovery is variable and can take months.
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Missed acetabular or femoral head fracture
Small rim fractures or Pipkin femoral head fractures are easy to miss on plain film — CT after reduction is essential.
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Chondral injury and loose bodies
A hip that dislocates almost always damages articular cartilage. Loose fragments in the joint need arthroscopic or open removal.
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Secondary osteoarthritis
Even a well-reduced hip has a lifetime risk of osteoarthritis — the joint has been through a significant injury.
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DVT and pulmonary embolism
Immobility and lower-limb trauma both raise thrombosis risk. Chemical prophylaxis is standard unless contraindicated.
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Red flags
Fever, calf pain and swelling, chest pain or breathlessness, worsening leg pain or new foot drop after discharge — same-day A&E, not a routine appointment.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever manoeuvre was used, the discharge note from an orthopaedic trauma unit keeps to the same shape.
A quiet reminder
Orthopaedic language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the operation note and the post-reduction CT before your outpatient review, just ask.
- 01 Header
Mechanism, direction and imaging
How the dislocation happened, whether it was posterior or anterior, and what the pre-reduction films showed.
- 02 Technique
Anaesthetic and reduction manoeuvre
Whether GA or sedation was used, the technique (Allis, Bigelow, Stimson, Captain Morgan), and how many attempts were needed.
- 03 Findings
Post-reduction CT and associated injury
Joint congruity, any loose bodies, acetabular or femoral head fractures, and any documented sciatic nerve deficit.
- 04 Impression
Hip precautions and follow-up
Read this first: weight-bearing status, hip precautions, DVT prophylaxis, when to see orthopaedics and when to book the AVN screening MRI.
Recognised by major UK insurers
Emergency reductions are managed on the NHS pathway. Private cover typically applies to post-reduction imaging, orthopaedic follow-up and any elective revision surgery.
Frequently asked
Everything we get asked about hip reduction.
Quick answers on urgency, anaesthetic, risks, recovery and what to watch for after discharge.
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What is a closed reduction of a dislocated hip?
A manoeuvre performed by an orthopaedic surgeon — under general anaesthetic in theatre — to put a dislocated hip back into its socket without cutting the skin. Techniques include Allis, Bigelow, Stimson and Captain Morgan.
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Why does it need to happen so quickly?
The femoral head has a fragile blood supply. If it stays out of the socket for more than about 6 hours, the risk of avascular necrosis (bone death) rises sharply. The target is under 60 minutes from arrival where possible.
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Why is a general anaesthetic needed?
The muscles around the hip are the strongest in the body. Without full muscle relaxation under GA, the reduction is often impossible, damages cartilage, and can fracture the femur.
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What are the main risks of hip dislocation itself?
Avascular necrosis of the femoral head, sciatic nerve palsy (foot drop), associated acetabular or femoral head fractures, chondral injury with loose bodies in the joint, secondary osteoarthritis, and DVT or pulmonary embolism from immobility.
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Why is a CT scan needed after the reduction?
Plain X-rays miss small rim fractures, femoral head fractures (Pipkin injuries) and loose bodies in the joint. CT confirms concentric reduction and picks up injuries that change management.
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What happens if closed reduction fails?
After two or three well-performed attempts under GA, the hip is deemed irreducible closed — usually because soft tissue or bone is trapped in the joint. Formal open reduction in theatre is then needed.
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What about a dislocated hip replacement?
A dislocated total hip replacement is usually reducible closed under sedation or GA. Recurrent dislocations after a hip replacement typically need revision surgery or an abduction brace.
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How long is the recovery?
Protected weight-bearing and hip precautions for six weeks is typical for a simple native hip dislocation. Full recovery — and the point at which AVN risk becomes clearer — is judged over three to six months.
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When should I see A&E urgently after discharge?
Fever, spreading redness, worsening leg pain, new foot drop, calf pain or swelling, chest pain or breathlessness — go to A&E the same day, do not wait for a clinic appointment.
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Can it happen again?
A native hip that has dislocated once has a small but real risk of doing so again, especially in the first few weeks. That is why hip precautions and follow-up matter.
Related tests
Looking for something else?
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X-ray
First-line imaging for suspected hip dislocation.
Learn more -
Musculoskeletal MRI
For avascular necrosis screening at six weeks.
Learn more -
Closed reduction of broken bones
Non-surgical reduction of fractures under anaesthetic.
Learn more -
All tests
Every test and procedure we arrange.
Learn more -
Osteoarthritis Hip Knee
Related condition guide.
Learn more -
Plantar Fasciitis
Related condition guide.
Learn more
In practice, in London
How closed reduction hip dislocation tends to unfold when you go private
For closed reduction hip dislocation, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. On the NHS, closed reduction hip dislocation typically sits behind a triage step and a wait that can stretch from a few weeks into months. In London’s private sector, the same appointment often lands within days. That speed matters when symptoms are disrupting work, sleep, or a plan you’d already committed to — and it’s the single most common reason people call us in the first place.
A typical private booking for closed reduction hip dislocation in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For closed reduction hip dislocation in particular, we bias towards consultants who do this every week rather than every month.
We’re careful about what a private pathway for closed reduction hip dislocation can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.