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