Modified Milch Technique : A Safe and Painless Method for Reduction of Anterior Shoulder Dislocation.
Keywords:
Milch technique, anterior dislocation of the shoulder, Shoulder reduction
Abstract
Background: The shoulder is the most commonly dislocated major joint in the body and this dislocation causes severe and agonizing pain. Prompt and painless reduction forms the cornerstone of treatment. We studied the efficacy of the Milch technique in the reduction of anterior dislocation of shoulder.
Materials: Between September 2011 and March 2014, 60 cases of anterior dislocation of shoulder were reduced by Milch technique in C.S Hospital Shivamogga and Dhruva Orthopaedic Clinic Shivamogga and the pain experienced by the patient was quantified by Visual Analogue Score.
Results: Reduction was successful in 56 cases (93.3%). The mean Visual Analogue score was 1.82. There were no complications.
Conclusion: We conclude that the Milch technique is a very effective and relatively painless method for reducing anterior dislocation of the shoulder.
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References
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16. Miljesic S, Kelly AM. Reduction of anterior dislocation of shoulder by Spaso technique. Emerg Medicine 1998; 10: 173-5.
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26. Mattick.A, Wyatt J.P. From Hippocrates to the Eskimo - a history of techniques used to reduce anterior dislocation of the shoulder. J.R.Coll.Surg.Edinb .October 2000; 45: 312-316. [PubMed]
27. 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;18:370-372.
28. Tsoi LCH, Wong MCK. FARES method to reduce acute anterior shoulder dislocation: a case series and an efficacy analysis. Hong Kong j. emerg. Med. Jan 2012; 19(1): 65-9. [PubMed]
29. McNamara R.M. Reduction of anterior shoulder dislocations by scapular manipulation. Ann Emerg Med. 1993 Jul;22(7):1140-4. [PubMed]
30. Janecki CJ, Shahcheragh GH. The forward elevation maneuver for reduction of anterior dislocations of the shoulder. Clin Orthop 1982;(164):177-80.
31. Harnroongroj T, Keeratipongpaiboon K, Lertudomphonwanit T, Harnroongroj T. Sedative-free Reduction of Acute Anterior Shoulder Dislocation Saves Post reduction Service time in the Emergency Room. Thai J Surg. 2001 Apr-June; 32(2): 49-52.
32. Milch H. Treatment of dislocation of the shoulder. Surg 1938; 3: 732-40. [PubMed]
33. O’ Conner DR, Schwarze D, Perdomo M, Fragomen AT. Painless reduction of acute anterior shoulder dislocation without anaesthesia. Orthopedics. 2006 June; 29(6): 528-32.
34. Russel JA, Holmes EM 3rd, Keller DJ, Vargas JH 3rd. Reduction of acute anterior shoulder dislocations using the Milch technique: A study of ski injuries. J Trauma 1981; 21(9): 802-4. [PubMed]
35. Singh S, Yong CK, Mariapan S. Closed reduction techniques in acute anterior shoulder dislocation: Modified Milch technique compared with traction- counter traction technique. J Shoulder Elbow Surg 2012; 21(12): 1706-11. [PubMed]
36. Garnavos C, Technical Note: modifications and improvements of the Milch technique for the reduction of anterior dislocation of the shoulders without premedication. J Trauma 1992; 32(6): 801-3.
2. Westin CD, Gill EA, Noyes ME, Hubbard M. Anterior shoulder dislocation. A simple and rapid method for reduction. Am J Sports Med. May-Jun 1995; 23(3): 369-71. [PubMed]
3. Kwon YW, Kulwicki KJ, Zuckerman JD, Glenohumeral Joint Subluxations, Dislocations, and stability in: Bucholz RW, Heckman JD, Court-brown CM, Tornetta P. Rockwood and Green’s fractures in adults 7th edition.Philedelphia 2010: 1285-1330.
4. Vissen CP, Coene LN, Brand R, Tavy DL. The incidence of nerve injury in anterior dislocation of the shoulder and its influence on functional recovery. A prospective clinical and EMG study. J Bone Joint Surg Br 1999 Jul; 81(4): 679-85. [PubMed]
5. Kralinger FS, Golser K, Wischatta R, Wambacher M, Gernot S. Predicting recurrence after primary anterior shoulder dislocation. Am J Sports Med. 2002 Jan-Feb; 30(1): 116-20. [PubMed]
6. Hoelen MA, Burgers AM, Rozing PM. Prognosis of primary anterior shoulder dislocation in young adults. Arch Orthop Trauma Surg. 1990; 110(1): 51-4. [PubMed]
7. Vermeiran J, Handelberg F, Casteleyn PP, Opdecam P. The rate of recurrence of traumatic anterior dislocation of the shoulder. A study of 154 cases and a review of the literature. Int Orthop. 1993 Dec; 17(6): 337-41. [PubMed]
8. Cunningham NJ. Technique for reduction of antero inferior dislocation. Emerg Med Australas. 2005 Oct-Dec; 17(5-6): 463-71. [PubMed]
9. Chung CH. Closed reduction technique for acute anterior shoulder dislocation: from Egyptians to Australians. Hong Kong J Emerg Med. 2004 Jul; 11(3): 178-88.
10. Thakur AJ, Narayan R. Painless reduction of shoulder dislocation by Kocher’s method. J Bone Joint Surg Br. 1990; 72 : 524. [PubMed]
11. Amar E, Maman E, Khashan M, Kauffman E, Rath E, Chechiko. Milch versus Stimson technique for non sedated reduction of anterior shoulder dislocation: a prospective randomized trial and analysis of factors affecting success. J shoulder Elbow Surg. 2012 Nov; 21(11): 1443-9.
12. Noordeen MH, Bacarese-Hamilton IH, Belham GJ, Kirwan EO. Anterior dislocation of the shoulder: A simple method for reduction. Injury 1992; 23 : 479-80. [PubMed]
13. Mahiroğullari M, Akyildiz F, Kőksal I, Cakmak S, Kűrklű M, kuşkucu M. Chair method: A simple and safe method for reduction of anterior shoulder dislocation. Acta Orthop Traumatol Turc. 2012; 46(2): 102-6.
14. Marinelli M, de Palma L. The external rotation method for reduction of acute anterior shoulder dislocations. J Orthop Traumatol. 2009 Mar; 10(1): 17-20. [PubMed]
15. Ceroni D, Sadri H, Levenberger A. Antero inferior shoulder dislocation: An auto-reduction method without analgesia. J Orthop Trauma. 1997 Aug; 11(6): 399-404.
16. Miljesic S, Kelly AM. Reduction of anterior dislocation of shoulder by Spaso technique. Emerg Medicine 1998; 10: 173-5.
17. Yuen MC, Tung WK. Reducing anterior shoulder dislocation by the Spaso technique. Hong Kong J Emerg Med. 2001 Apr; 8(2): 96-100. [PubMed]
18. Bosley RC, Miles JC. Scapula manipulation for reduction of anterior dislocations: A new procedure. AAOS 1979: 23.
19. 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 2005; 22: 336-8.
20. Johnson G, Hulse W, McGowan A. The Milch technique for reduction of anterior shoulder in an accident and emergency department. Arch Emerg Med. 1992 Mar; 9(1): 40-3. [PubMed]
21. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, Kvarstein G, Stubhaug A. Assessment of pain. Br J Anaesth. 2008 Jul;101(1):17-24. doi: 10.1093/bja/aen103. Epub 2008 May 16. [PubMed]
22. 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): 349-52.
23. Boger D, Sipsey J, Anderson G. New traction devices to aid reduction of shoulder dislocations. Ann Emerg Med 1984;13(6):423-5. [PubMed]
24. Leidelmeyer R. Reduced! A shoulder, subtly and painlessly. J Emerg Med 1977:9:223-34.
25. Regauer M, Polzer H, Mutschler W. Neurovascular complications due to the Hippocrates method for reducing anterior shoulder dislocations. World J Orthop 2014 January 18; 5(1): 57-61. [PubMed]
26. Mattick.A, Wyatt J.P. From Hippocrates to the Eskimo - a history of techniques used to reduce anterior dislocation of the shoulder. J.R.Coll.Surg.Edinb .October 2000; 45: 312-316. [PubMed]
27. 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;18:370-372.
28. Tsoi LCH, Wong MCK. FARES method to reduce acute anterior shoulder dislocation: a case series and an efficacy analysis. Hong Kong j. emerg. Med. Jan 2012; 19(1): 65-9. [PubMed]
29. McNamara R.M. Reduction of anterior shoulder dislocations by scapular manipulation. Ann Emerg Med. 1993 Jul;22(7):1140-4. [PubMed]
30. Janecki CJ, Shahcheragh GH. The forward elevation maneuver for reduction of anterior dislocations of the shoulder. Clin Orthop 1982;(164):177-80.
31. Harnroongroj T, Keeratipongpaiboon K, Lertudomphonwanit T, Harnroongroj T. Sedative-free Reduction of Acute Anterior Shoulder Dislocation Saves Post reduction Service time in the Emergency Room. Thai J Surg. 2001 Apr-June; 32(2): 49-52.
32. Milch H. Treatment of dislocation of the shoulder. Surg 1938; 3: 732-40. [PubMed]
33. O’ Conner DR, Schwarze D, Perdomo M, Fragomen AT. Painless reduction of acute anterior shoulder dislocation without anaesthesia. Orthopedics. 2006 June; 29(6): 528-32.
34. Russel JA, Holmes EM 3rd, Keller DJ, Vargas JH 3rd. Reduction of acute anterior shoulder dislocations using the Milch technique: A study of ski injuries. J Trauma 1981; 21(9): 802-4. [PubMed]
35. Singh S, Yong CK, Mariapan S. Closed reduction techniques in acute anterior shoulder dislocation: Modified Milch technique compared with traction- counter traction technique. J Shoulder Elbow Surg 2012; 21(12): 1706-11. [PubMed]
36. Garnavos C, Technical Note: modifications and improvements of the Milch technique for the reduction of anterior dislocation of the shoulders without premedication. J Trauma 1992; 32(6): 801-3.
CITATION
DOI: 10.17511/ijmrr.2014.i05.07
Published: 2014-10-31
How to Cite
1.
Chaitanya P, PR C, PR N, M P MP, Azeem A. Modified Milch Technique : A Safe and Painless Method for Reduction of Anterior Shoulder Dislocation. Int J Med Res Rev [Internet]. 2014Oct.31 [cited 2024Nov.8];2(5):439-43. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/136
Section
Original Article
OAI - Open Archives Initiative
