Adolescent health

March 2011

Research

Anterior shoulder dislocation

Seated versus traditional reduction technique

Volume 40, No.3, March 2011 Pages 133-137

Sadiq Jamali

Background

Anterior dislocation of the shoulder joint is a common presentation to hospital emergency departments (EDs).

Aim

To compare the requirement for sedation and length of ED stay utilising the author’s seated shoulder reduction technique (SRT) with traditional shoulder reduction (TSR) techniques in the ED.

Methods

A retrospective chart review of patients presenting to the ED between January 2005 and December 2007 was conducted. The review assessed technique, mean length of stay, sedation requirements and incidence of complications in patients who were treated with either the author’s SRT or with TSR.

Results

A total of 486 patient charts were reviewed and 404 met inclusion criteria. Patients were categorised into the SRT group: 66 (16.3%) and TSR group: 338 (83.7%). Mean age of the groups was 30 years (SRT) vs. 29 years (TSR), with 80% being male. Mean length of stay in the SRT group was 1.5 hours (95% CI: 1.1–1.9) vs. TSR 2.9 hours (95% CI: 2.3–2.9; p<0.001). Sedation was not required in patients in the SRT group, but was required for all patients in the TSR group. No complications were reported in either group.

Conclusion

In this study group, the author’s technique was successful in reducing anterior shoulder dislocation, without the need for sedation, and reduced length of ED stay when compared to TSR techniques.

Anterior dislocation of the shoulder (glenohumeral) joint is a common presentation to hospital emergency departments (ED) and accounts for 90–95% of all shoulder dislocations.1 Patients commonly presenting to EDs with anterior shoulder dislocation are aged 18–30 years as the aetiology of injury is commonly related to sporting activity. There are many anterior shoulder reduction techniques (SRT), which can be categorised under four main headings of traction: counter traction, leverage, scapular manipulation, and combinations of these manoeuvres.2 While there are traditionally described standard techniques that head each group, such as Hippocratic, Kocher, Milch and Spaso methods, most recently published techniques are either variations or combinations of these traditional methods.1,3–8

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Correspondence afp@racgp.org.au

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