SpringerLink
Log in

A simple and gentle technique for reduction after anterior shoulder dislocation

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Anterior shoulder dislocation (ASD) is a common sports injury. The goal of this study was to evaluate a new procedure for reduction after ASD with respect to success rate, the need for medication for muscle relaxation, sedation, and application of pain medication and put it into context to a systematic literature review.

Patients and methods

We retrospectively evaluated the new method in 263 patients in an Austrian skiing area from December 2005 till April 2009. We included patients with unilateral ASD and excluded those with a combined trauma and consecutive admission to hospital.

Results

The new procedure is performed in a supine position, the therapist takes the patients hand of the injured limb with his one hand and with his other hand counter holds against the acromion. Then he enhances the traction on the upper limp by using his trunk as a kind of fulcrum. With eye contact and instructions to relax, the therapist is able to detect the muscular tension, so that he can adjust the amount of traction accordingly. The presented procedure was successful in all reported cases. For 196 patients (74.5 %) no medication for muscle relaxation, sedation, or pain medication were needed.

Conclusion

The new method is a promising option to popular techniques for reduction of anterior shoulder dislocations. The benefits of this protocol are a gentle and simple application of the procedure as well as an easy acquisition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Walz M, Kolbow B, Auerbach F (2006) A simple gentle and painless technique for reduction of anterior shoulder dislocation. Unfallchirurg 109:551–555. doi:10.1016/j.acpain.2006.09.009

    Article  CAS  PubMed  Google Scholar 

  2. Westin CD, Gill EA, Noyes ME, Hubbard M (1995) Anterior shoulder dislocation. A simple and rapid method for reduction. Am J Sports Med 23:369–371. doi:10.1177/036354659502300322

    Article  CAS  PubMed  Google Scholar 

  3. McCall D, Safran MR (2009) Injuries about the shoulder in skiing and snowboarding. Br J Sports Med 43:987–992. doi:10.1136/bjsm.2009.068767

    Article  CAS  PubMed  Google Scholar 

  4. Kuriyama S, Fujimaki E, Katagiri T, Uemura S (1994) Anterior dislocation of the shoulder joint sustained through skiing. Am J Sports Med 12:339–346. doi:10.1177/036354658401200501

    Article  Google Scholar 

  5. Russell JA, Holmes EM, Keller DJ, Vargas JH (1981) Reduction of acute anterior shoulder dislocation using the Milch technique: a study of ski injuries. J Trauma 21:802–804. doi:10.1097/00005373-198109000-00009

    Article  CAS  PubMed  Google Scholar 

  6. Caudevilla Polo S, Estébanez de Miguel E, Lucha López O, Tricás Moreno JM, Pérez Guillén S (2011) Humerus axial traction with acromial fixation reduction maneuver for anterior shoulder dislocation. J Emerg Med 41:282–284. doi:10.1016/j.jemermed.2010.11.054

    Article  PubMed  Google Scholar 

  7. Bühren V, Trenz O (2005) Checkliste traumatologie, 6th edn. Georg Thieme Verlag, Stuttgard, pp 393–398

    Google Scholar 

  8. Pishbin E, Bolvardi E, Ahmadi K (2011) Scapular manipulation for reduction of anterior shoulder dislocation without analgesia: results of a prospective study. Emerg Med Australas 23:54–58. doi:10.1111/j.1742-6723.2010.01374.x

    Article  PubMed  Google Scholar 

  9. Ufberg JW, Vilke GM, Chan TC, Harigan RA (2004) Anterior shoulder dislocations: beyond traction–countertraction. J Emerg Med 27:301–306. doi:10.1016/j.jemermed.2004.04.013

    Article  PubMed  Google Scholar 

  10. Regauer M, Tischer T, Kanz KG, Schieker M, Kettler M, Mutschler W (2005) Anterior dislocation of the shoulder; a reduction technique that is easy on the patient. MMW Fortschr Med 147:38–41

    CAS  PubMed  Google Scholar 

  11. Manes HR (1980) A new method of shoulder reduction in the elderly. Clin Orthop Relat Res 147:200–202. doi:10.1097/00003086-198003000-00035

    PubMed  Google Scholar 

  12. Eachempati KK, Dua A, Malhotra R, Bhan S, Bera JR (2004) The external rotation method for reduction of acute anterior dislocations and fracture-dislocations of the shoulder. J Bone Joint Surg Am 86-A:2431–2434

    PubMed  Google Scholar 

  13. Ceroni D, Sadri H, Leuenberger A (1997) Anterioinferior shoulder dislocation: an auto-reduction method without analgesia. J Orthop Trauma 11:399–404. doi:10.1097/00005131-199708000-00003

    Article  CAS  PubMed  Google Scholar 

  14. Yuen MC, Yap PG, Chan YT, Tung WK (2001) An easy method to reduce anterior shoulder dislocation: the Spaso technique. Emerg Med J 18:370–372. doi:10.1136/emj.18.5.370

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Zahiri CA, Zahiri H, Tehrany F (1997) Anterior shoulder dislocation reduction technique—revisited. Orthopedics 20:515–521

    CAS  PubMed  Google Scholar 

  16. Baykal B, Sener S, Turkan H (2005) Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department. Emerg Med J 22:336–338. doi:10.1136/emj.2004.019752

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Noordeen MH, Bacarese-Hamilton IH, Belham GJ, Kirwan EO (1992) Anterior dislocation of the shoulder: a simple method of reduction. Injury 23:479–480. doi:10.1016/0020-1383(92)90068-4

    Article  CAS  PubMed  Google Scholar 

  18. Chitgopkar SD, Khan M (2005) Painless reduction of anterior shoulder dislocation by Kocher’s method. Injury 36:1182–1184. doi:10.1016/j.injury.2004.12.004

    Article  PubMed  Google Scholar 

  19. Uglow MG (1998) Kocher’s painless reduction of anterior dislocation of the shoulder: a prospective randomised trial. Injury 29:135–137. doi:10.1016/S0020-1383(97)00168-X

    Article  CAS  PubMed  Google Scholar 

  20. Berkenblit SI, Hand MB, MacAusland WR (2000) Reduction of skiing-related anterior shoulder dislocation using Kocher’s method without traction. Am J Orthop (Belle Mead NJ) 29:811–814

    CAS  Google Scholar 

  21. Fernández-Valencia JA, Cuñe J, Casulleres JM, Carreño A, Prat S (2009) The Spaso technique: a prospective study of 34 dislocations. Am J Emerg Med 27:466–469. doi:10.1016/j.ajem.2008.03.040

    Article  PubMed  Google Scholar 

  22. Johnson G, Hulse W, McGowan A (1992) The Milch technique for reduction of anterior shoulder dislocations in an accident and emergency department. Arch Emerg Med 9:40–43. doi:10.1136/emj.9.1.40

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6:e1000100. doi:10.1371/journal.pmed.1000100

    Article  PubMed Central  PubMed  Google Scholar 

  24. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses. Lancet 354:1896–1900. doi:10.1016/S0140-6736(99)04149-5

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anatomy, Medical University of Graz, Graz, Austria

    Manuel Dreu, Claudia Dolcet & Georg Feigl

  2. Private Hospital of Dr. Aufmesser, Radstadt/Obertauern, Austria

    Werner Aufmesser & Harald Aufmesser

  3. Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria

    Patrick Sadoghi

Authors
  1. Manuel Dreu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Werner Aufmesser
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Harald Aufmesser
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudia Dolcet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Georg Feigl
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Patrick Sadoghi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrick Sadoghi.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dreu, M., Aufmesser, W., Aufmesser, H. et al. A simple and gentle technique for reduction after anterior shoulder dislocation. Arch Orthop Trauma Surg 135, 1379–1384 (2015). https://doi.org/10.1007/s00402-015-2279-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-015-2279-6

Keywords

Search

Navigation