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Ann Emerg Med. 1993 Jul;22(7):1140-4.

Reduction of anterior shoulder dislocations by scapular manipulation.

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1
Department of Emergency Medicine, Medical College of Pennsylvania, Philadelphia.

Abstract

STUDY OBJECTIVES:

This study examined the success rate, time required, technical ease, and reported patient discomfort for the use of scapular manipulation in the reduction of anterior shoulder dislocation. This study included a new variation of this technique using the seated position.

DESIGN:

Prospective case series over a 19-month period.

SETTING:

The emergency departments of a university and a community hospital.

TYPE OF PARTICIPANTS:

Patients with anterior shoulder dislocations.

INTERVENTIONS:

Emergency medicine resident and attending physicians were instructed in the technique of scapular manipulation in a classroom setting and requested to use this method initially for the reduction of anterior shoulder dislocations. Premedication was at the physician's discretion.

MEASUREMENTS AND MAIN RESULTS:

There were 54 patients with 61 dislocations. Scapular manipulation was attempted by 19 residents and 12 attending physicians. The overall success rate of scapular manipulation was 79%, whereas that of physicians experienced with the technique was 86%. Of the successful reductions, 65% were performed in less than one minute, and physicians rated the technique as very easy or easy to perform in 74% of these cases. No premedication was used in 64% of the attempts at scapular manipulation, and these patients reported pain ratings similar to those of the premedicated groups. No complications were noted in this study.

CONCLUSION:

Scapular manipulation generally is a simple, rapid, and reliable technique for the reduction of anterior shoulder dislocation.

PMID:
8517564
DOI:
10.1016/s0196-0644(05)80979-5
[Indexed for MEDLINE]

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