Dislocations: Hippocratic method: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Dislocations: Hippocratic method

Sample item

In reducing an anterior shoulder dislocation by the Hippocratic method, what is applied?

AForced abduction and internal rotation under no analgesiaBLeverage with the elbow flexed and rapid external rotation past 90 degreesCManipulation with the arm held behind the backDGentle traction on the arm with the physician's stockinged foot in the axilla as countertraction

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Gentle traction on the arm with the physician's stockinged foot in the axilla as countertraction

Hippocrates method uses steady longitudinal traction of the arm while the heel of the surgeon's foot in the axilla provides countertraction and acts as a fulcrum. Kocher method, in contrast, uses slow external rotation, adduction and then internal rotation, and carries a fracture risk.

Option by option

A. Forced abduction and internal rotation under no analgesia
Forced manipulation without analgesia can cause fractures and is not the method.
B. Leverage with the elbow flexed and rapid external rotation past 90 degrees
Leverage with rapid rotation describes Kocher manoeuvre elements and risks humeral fracture.
C. Manipulation with the arm held behind the back
Placing the arm behind the back is not a standard reduction technique.
D. Gentle traction on the arm with the physician's stockinged foot in the axilla as countertraction (correct)
Correct. Traction with the foot in the axilla is the Hippocratic technique.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Gentle traction on the arm with the physician's stockinged foot in the axilla as countertraction. Hippocrates method uses steady longitudinal traction of the arm while the heel of the surgeon's foot in the axilla provides countertraction and acts as a fulcrum.

Why is "Forced abduction and internal rotation under no analgesia" not the answer?

Forced manipulation without analgesia can cause fractures and is not the method.

Why is "Leverage with the elbow flexed and rapid external rotation past 90 de…" not the answer?

Leverage with rapid rotation describes Kocher manoeuvre elements and risks humeral fracture.

Why is "Manipulation with the arm held behind the back" not the answer?

Placing the arm behind the back is not a standard reduction technique.

What concept does this question test?

It tests Dislocations: Hippocratic method in Orthopaedics. Kocher method, in contrast, uses slow external rotation, adduction and then internal rotation, and carries a fracture risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Dislocations: Hippocratic method?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.