Comparison of four different reduction methods for anterior dislocation of the shoulder
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RESEARCH ARTICLE
Open Access
Comparison of four different reduction methods for anterior dislocation of the shoulder Olcay Guler1*, Safak Ekinci2, Faruk Akyildiz3, Uzeyir Tirmik4, Selami Cakmak5, Akin Ugras1, Ahmet Piskin6 and Mahir Mahirogullari1
Abstract Background: Shoulder dislocations account for almost 50 % of all major joint dislocations and are mainly anterior. Objective: The aim is a comparative retrospective study of different reduction maneuvers without anesthesia to reduce the dislocated shoulder. Methods: Patients were treated with different reduction maneuvers, including various forms of traction and external rotation, in the emergency departments of four training hospitals between 2009 and 2012. Each of the four hospitals had different treatment protocols for reduction and applying one of four maneuvers: Spaso, Chair, Kocher, and Matsen methods. Thirty-nine patients were treated by the Spaso method, 47 by the Chair reduction method, 40 by the Kocher method, and 27 patients by Matsen’s traction-countertraction method. All patients’ demographic data were recorded. Dislocation number, reduction time, time interval between dislocation and reduction, and associated complications, pre- and post-reduction period, were recorded prospectively. No anesthetic method was used for the reduction. Results: All of the methods used included traction and some external rotation. The Chair method had the shortest reduction time. All surgeons involved in the study agreed that the Kocher and Matsen methods needed more force for the reduction. Patients could contract their muscles because of the pain in these two methods. The Spaso method includes flexion of the shoulder and blocks muscle contraction somewhat. The Chair method was found to be the easiest because the patients could not contract their muscles while sitting on a chair with the affected arm at their side. Conclusions: We suggest that the Chair method is an effective and fast reduction maneuver that may be an alternative for the treatment of anterior shoulder dislocations. Further prospective studies with larger sample size are needed to compare safety of different reduction techniques. Keywords: Shoulder, Anterior shoulder dislocation, Closed reduction
Background Shoulder dislocations account for nearly 50 % of all major joint dislocations presenting to emergency departments [1]. Very often, shoulder dislocations are anterior (90–98 %) and occur due to trauma [2]. The primary anterior dislocation incidence is estimated to be around 12.3 per 100,000 people [3]. Many reduction methods have been described in the literature [1]. The methods include different reduction maneuvers. However, few studies have compared the efficacy, reliability, and safety of the various techniques
[1–3]. As a result, deciding which technique to use is seldom based on objective criteria. Which method is superior is also unclear. An “ideal” reduction method would be effective, rapid, and as painless as possible for patients and should not cause iatrogenic complications. The aim of t
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