A meta-analytic comparison of 8 methods of closed anterior shoulder dislocation reduction
Keywords:
Shoulder Dislocation, Orthopedics, Emergency Medicine
Abstract
Background: Anterior shoulder dislocation is a common injury, accounting for 95% of all shoulder injuries. However, many doctors and hospitals do not have a fixed protocol for the treatment of dislocations. The current study have compared 8 different techniques for shoulder dislocation reduction in this study.
Methods: Eight different methods namely the Scapular Manipulation, Matsen’s Traction-Countertraction, Kocher’s, Spaso, External Rotation, Cunningham, Modified Milch, and the FARES methods were compared on the basis of efficacy, pain experienced during reduction (VAS score), and time taken for reduction.
Results: The Matsen’s Traction-Countertraction method had the highest efficacy, while the Scapular Manipulation method had the least VAS scoring. The FARES Method had the fastest reduction time on average. Interpretation and
Conclusions: As per the data analyzed, the FARES and Scapular Manipulation method appear to be the most effective in reducing anterior dislocations, having consistently high success rates, and low VAS scores and reduction times. These 2 methods may be recommended to new practitioners to treat acute shoulder dislocations.
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References
CITATIONS
1. Goss TP. Anterior glenohumeral instability. Orthopedics 1988;11:87-95.
2. Ufberg J, McNamara R. Jacob Ufberg, Robert McNamara. Management of common dislocations. In: Roberts RR, Hedges JR, eds. Clinical procedures in emergency medicine, 4th ed. New York, NY: McGraw Hill, 2004:948–57. 10 Kothari RU, Dronen SC. The scapular manipulation techni. In: Clinical Procedures in Emergency Medicine, 4th Ed. 4th ed. McGraw Hill; 2004:948-957.
3. Baykal B, Sener S, Turkan H. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department. Emerg Med J EMJ. 2005;22(5):336-338. doi:10.1136/emj.2004.019752
4. Guler O, Ekinci S, Akyildiz F, et al. Comparison of four different reduction methods for anterior dislocation of the shoulder. J Orthop Surg Res. 2015;10. doi:10.1186/s13018-015-0226-4
5. Watson-Jones R. Fractures and joint injuries. In: Vol 2. 6th ed. Churchill Livingstone; 1982.
6. Vasudevan TK, Ramlal RD, Samraj A. Success outcome of reduction in anterior shoulder dislocation by FARES method. In: ; 2015. doi:10.18203/2320-6012.ijrms20151456
7. Marinelli M, de Palma L. The external rotation method for reduction of acute anterior shoulder dislocations. J Orthop Traumatol Off J Ital Soc Orthop Traumatol. 2009;10(1):17-20. doi:10.1007/s10195-008-0040-4
8. Cunningham N. A new drug free technique for reducing anterior shoulder dislocations. Emerg Med Fremantle WA. 2003;15(5-6):521-524.
9. Garnavos C. Technical note: modifications and improvements of the Milch technique for the reduction of anterior dislocation of the shoulder without premedication. J Trauma. 1992;32(6):801-803. doi:10.1097/00005373-199206000-00023
10. Kothari RU, Dronen SC. Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations. Ann Emerg Med. 1992;21(11):1349-1352. doi:10.1016/s0196-0644(05)81900-6
11. Sahin N, Oztürk A, Ozkan Y, Atıcı T, Ozkaya G. A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. Eklem Hast Ve Cerrahisi Jt Dis Relat Surg. 2011;22(1):28-32.
12. Anderson D, Zvirbulis R, Ciullo J. Scapular manipulation for reduction of anterior shoulder dislocations. Clin Orthop. 1982;(164):181-183.
13. McNamara RM. Reduction of anterior shoulder dislocations by scapular manipulation. Ann Emerg Med. 1993;22(7):1140-1144. doi:10.1016/S0196-0644(05)80979-5
14. Ghane M-R, Hoseini S-H, Javadzadeh H-R, Mahmoudi S, Saburi A. Comparison between traction-countertraction and modified scapular manipulation for reduction of shoulder dislocation. Chin J Traumatol. 2014;17(2):93-98. doi:10.3760/cma.j.issn.1008-1275.2014.02.007
15. Boger D, Sipsey J, Anderson G. New traction devices to aid reduction of shoulder dislocations. Ann Emerg Med. 1984;13(6):423-425. doi:10.1016/s0196-0644(84)80004-9
16. Singh S, Yong CK, Mariapan S. Closed reduction techniques in acute anterior shoulder dislocation: modified Milch technique compared with traction-countertraction technique. J Shoulder Elbow Surg. 2012;21(12):1706-1711. doi:10.1016/j.jse.2012.04.004
17. Maity A, Roy DS, Mondal BC. A prospective randomised clinical trial comparing FARES method with the Eachempati external rotation method for reduction of acute anterior dislocation of shoulder. Injury. 2012;43(7):1066-1070. doi:10.1016/j.injury.2012.01.019
18. Jeyarajan R, Cope AR. Anaesthesia for reduction of anterior dislocations of the shoulder. Arch Emerg Med. 1992;9(1):71.
19. Danzl DF, Vicario SJ, Gleis GL, Yates JR, Parks DL. Closed reduction of anterior subcoracoid shoulder dislocation. Evaluation of an external rotation method. Orthop Rev. 1986;15(5):311-315.
20. te Slaa RL, Wijffels MPJM, Marti RK. Questionnaire reveals variations in the management of acute first time shoulder dislocations in the Netherlands. Eur J Emerg Med Off J Eur Soc Emerg Med. 2003;10(1):58-61. doi:10.1097/00063110-200303000-00015
21. Banerjee A. Is anaesthesia necessary for reducing shoulder dislocation? Arch Emerg Med. 1990;7(3):240. doi:10.1136/emj.7.3.240
22. Mirick MJ, Clinton JE, Ruiz E. External rotation method of shoulder dislocation reduction. J Am Coll Emerg Physicians. 1979;8(12):528-531. doi:10.1016/S0361-1124(79)80302-0
23. Fernández-Valencia JA, Cuñe J, Casulleres JM, Carreño A, Prat S. The Spaso technique: a prospective study of 34 dislocations. Am J Emerg Med. 2009;27(4):466-469. doi:10.1016/j.ajem.2008.03.040
24. Yuen M-C, Yap P-G, Chan Y-T, Tung W-K. An easy method to reduce anterior shoulder dislocation: the Spaso technique. Emerg Med J. 2001;18(5):370-372. doi:10.1136/emj.18.5.370
25. Rezende B da RM, de Almeida JI, de Sousa UJ, Bomfim L de S, Ferreira MS. Glenoumeral dislocation: a prospective randomized study comparing spazo and kocher maneuvers. Acta Ortop Bras. 2015;23(4):192-196. doi:10.1590/1413-78522015230400701
26. Beattie TF, Steedman DJ, McGowan A, Robertson CE. A comparison of the Milch and Kocher techniques for acute anterior dislocation of the shoulder. Injury. 1986;17(5):349-352. doi:10.1016/0020-1383(86)90161-0
27. Berkenblit SI, Hand MB, MacAusland WR. Reduction of skiing-related anterior shoulder dislocation using Kocher’s method without traction. Am J Orthop Belle Mead NJ. 2000;29(10):811-814.
28. Royle G. Treatment of acute anterior dislocation of the shoulder. Br J Clin Pract. 1973;27(11):403-404.
29. Pr C, Pr C, Pr N, P SM, Azeem A. Modified Milch Technique : A Safe and Painless Method for Reduction of Anterior Shoulder Dislocation. Int J Med Res Rev. 2014;2(05). http://medresearch.in/index.php/IJMRR/article/view/152. Accessed November 10, 2019.
30. Gudmundsson TH, Bjornsson HM. [Reduction of shoulder dislocation with the Cunningham method]. Laeknabladid. 2017;103(9):373-376. doi:10.17992/lbl.2017.09.150
31. Tsoi L, Wong M. FARES Method to Reduce Acute Anterior Shoulder Dislocation: A Case Series and an Efficacy Analysis. Hong Kong J Emerg Med. 2012;19(1):65-69. doi:10.1177/102490791201900113
32. Sayegh FE, Kenanidis EI, Papavasiliou KA, Potoupnis ME, Kirkos JM, Kapetanos GA. Reduction of acute anterior dislocations: a prospective randomized study comparing a new technique with the Hippocratic and Kocher methods. J Bone Joint Surg Am. 2009;91(12):2775-2782. doi:10.2106/JBJS.H.01434
33. Egger M, Smith G. Meta-analysis: Bias in location and selection of studies. BMJ. 1998;316:61-66.
1. Goss TP. Anterior glenohumeral instability. Orthopedics 1988;11:87-95.
2. Ufberg J, McNamara R. Jacob Ufberg, Robert McNamara. Management of common dislocations. In: Roberts RR, Hedges JR, eds. Clinical procedures in emergency medicine, 4th ed. New York, NY: McGraw Hill, 2004:948–57. 10 Kothari RU, Dronen SC. The scapular manipulation techni. In: Clinical Procedures in Emergency Medicine, 4th Ed. 4th ed. McGraw Hill; 2004:948-957.
3. Baykal B, Sener S, Turkan H. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department. Emerg Med J EMJ. 2005;22(5):336-338. doi:10.1136/emj.2004.019752
4. Guler O, Ekinci S, Akyildiz F, et al. Comparison of four different reduction methods for anterior dislocation of the shoulder. J Orthop Surg Res. 2015;10. doi:10.1186/s13018-015-0226-4
5. Watson-Jones R. Fractures and joint injuries. In: Vol 2. 6th ed. Churchill Livingstone; 1982.
6. Vasudevan TK, Ramlal RD, Samraj A. Success outcome of reduction in anterior shoulder dislocation by FARES method. In: ; 2015. doi:10.18203/2320-6012.ijrms20151456
7. Marinelli M, de Palma L. The external rotation method for reduction of acute anterior shoulder dislocations. J Orthop Traumatol Off J Ital Soc Orthop Traumatol. 2009;10(1):17-20. doi:10.1007/s10195-008-0040-4
8. Cunningham N. A new drug free technique for reducing anterior shoulder dislocations. Emerg Med Fremantle WA. 2003;15(5-6):521-524.
9. Garnavos C. Technical note: modifications and improvements of the Milch technique for the reduction of anterior dislocation of the shoulder without premedication. J Trauma. 1992;32(6):801-803. doi:10.1097/00005373-199206000-00023
10. Kothari RU, Dronen SC. Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations. Ann Emerg Med. 1992;21(11):1349-1352. doi:10.1016/s0196-0644(05)81900-6
11. Sahin N, Oztürk A, Ozkan Y, Atıcı T, Ozkaya G. A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. Eklem Hast Ve Cerrahisi Jt Dis Relat Surg. 2011;22(1):28-32.
12. Anderson D, Zvirbulis R, Ciullo J. Scapular manipulation for reduction of anterior shoulder dislocations. Clin Orthop. 1982;(164):181-183.
13. McNamara RM. Reduction of anterior shoulder dislocations by scapular manipulation. Ann Emerg Med. 1993;22(7):1140-1144. doi:10.1016/S0196-0644(05)80979-5
14. Ghane M-R, Hoseini S-H, Javadzadeh H-R, Mahmoudi S, Saburi A. Comparison between traction-countertraction and modified scapular manipulation for reduction of shoulder dislocation. Chin J Traumatol. 2014;17(2):93-98. doi:10.3760/cma.j.issn.1008-1275.2014.02.007
15. Boger D, Sipsey J, Anderson G. New traction devices to aid reduction of shoulder dislocations. Ann Emerg Med. 1984;13(6):423-425. doi:10.1016/s0196-0644(84)80004-9
16. Singh S, Yong CK, Mariapan S. Closed reduction techniques in acute anterior shoulder dislocation: modified Milch technique compared with traction-countertraction technique. J Shoulder Elbow Surg. 2012;21(12):1706-1711. doi:10.1016/j.jse.2012.04.004
17. Maity A, Roy DS, Mondal BC. A prospective randomised clinical trial comparing FARES method with the Eachempati external rotation method for reduction of acute anterior dislocation of shoulder. Injury. 2012;43(7):1066-1070. doi:10.1016/j.injury.2012.01.019
18. Jeyarajan R, Cope AR. Anaesthesia for reduction of anterior dislocations of the shoulder. Arch Emerg Med. 1992;9(1):71.
19. Danzl DF, Vicario SJ, Gleis GL, Yates JR, Parks DL. Closed reduction of anterior subcoracoid shoulder dislocation. Evaluation of an external rotation method. Orthop Rev. 1986;15(5):311-315.
20. te Slaa RL, Wijffels MPJM, Marti RK. Questionnaire reveals variations in the management of acute first time shoulder dislocations in the Netherlands. Eur J Emerg Med Off J Eur Soc Emerg Med. 2003;10(1):58-61. doi:10.1097/00063110-200303000-00015
21. Banerjee A. Is anaesthesia necessary for reducing shoulder dislocation? Arch Emerg Med. 1990;7(3):240. doi:10.1136/emj.7.3.240
22. Mirick MJ, Clinton JE, Ruiz E. External rotation method of shoulder dislocation reduction. J Am Coll Emerg Physicians. 1979;8(12):528-531. doi:10.1016/S0361-1124(79)80302-0
23. Fernández-Valencia JA, Cuñe J, Casulleres JM, Carreño A, Prat S. The Spaso technique: a prospective study of 34 dislocations. Am J Emerg Med. 2009;27(4):466-469. doi:10.1016/j.ajem.2008.03.040
24. Yuen M-C, Yap P-G, Chan Y-T, Tung W-K. An easy method to reduce anterior shoulder dislocation: the Spaso technique. Emerg Med J. 2001;18(5):370-372. doi:10.1136/emj.18.5.370
25. Rezende B da RM, de Almeida JI, de Sousa UJ, Bomfim L de S, Ferreira MS. Glenoumeral dislocation: a prospective randomized study comparing spazo and kocher maneuvers. Acta Ortop Bras. 2015;23(4):192-196. doi:10.1590/1413-78522015230400701
26. Beattie TF, Steedman DJ, McGowan A, Robertson CE. A comparison of the Milch and Kocher techniques for acute anterior dislocation of the shoulder. Injury. 1986;17(5):349-352. doi:10.1016/0020-1383(86)90161-0
27. Berkenblit SI, Hand MB, MacAusland WR. Reduction of skiing-related anterior shoulder dislocation using Kocher’s method without traction. Am J Orthop Belle Mead NJ. 2000;29(10):811-814.
28. Royle G. Treatment of acute anterior dislocation of the shoulder. Br J Clin Pract. 1973;27(11):403-404.
29. Pr C, Pr C, Pr N, P SM, Azeem A. Modified Milch Technique : A Safe and Painless Method for Reduction of Anterior Shoulder Dislocation. Int J Med Res Rev. 2014;2(05). http://medresearch.in/index.php/IJMRR/article/view/152. Accessed November 10, 2019.
30. Gudmundsson TH, Bjornsson HM. [Reduction of shoulder dislocation with the Cunningham method]. Laeknabladid. 2017;103(9):373-376. doi:10.17992/lbl.2017.09.150
31. Tsoi L, Wong M. FARES Method to Reduce Acute Anterior Shoulder Dislocation: A Case Series and an Efficacy Analysis. Hong Kong J Emerg Med. 2012;19(1):65-69. doi:10.1177/102490791201900113
32. Sayegh FE, Kenanidis EI, Papavasiliou KA, Potoupnis ME, Kirkos JM, Kapetanos GA. Reduction of acute anterior dislocations: a prospective randomized study comparing a new technique with the Hippocratic and Kocher methods. J Bone Joint Surg Am. 2009;91(12):2775-2782. doi:10.2106/JBJS.H.01434
33. Egger M, Smith G. Meta-analysis: Bias in location and selection of studies. BMJ. 1998;316:61-66.
CITATION
DOI: 10.17511/ijmrr.2020.i02.12
Published: 2020-04-30
How to Cite
1.
Iqbalbhai Sadikot M, Samir Shah J. A meta-analytic comparison of 8 methods of closed anterior shoulder dislocation reduction. Int J Med Res Rev [Internet]. 2020Apr.30 [cited 2024Nov.26];8(2):213-20. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1139
Section
Review Article
Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society
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