Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations.
OBJECTIVE
To evaluate the speed, efficacy, and safety of the scapular manipulation technique in reducing acute anterior shoulder dislocations.


METHODS
Prospective study.


METHODS
Urban emergency department with an annual census of 65,000 patients.


METHODS
Forty-eight adult patients with acute anterior shoulder dislocation.


METHODS
Patients had an initial neurovascular and radiographic evaluation performed. They were sedated with IV fentanyl and midazolam. The shoulder was reduced using the scapular manipulation technique. The patient was re-evaluated for any evidence of complication. The total dose of analgesic required and time to reduction were recorded.


RESULTS
The scapular manipulation technique was successful in 46 of 48 (96%) cases. The average time to reduction was 6.05 minutes, and no complications were detected. Average doses of 1.83 mg midazolam and 204 micrograms fentanyl were required for reduction.


CONCLUSIONS
The scapular manipulation technique is a very fast, effective, safe method of reducing anterior shoulder dislocations in the ED. [Kothari RU, Dronen SC: Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations.
Kothari
R U
RU
Department of Emergency Medicine, University of Cincinnati College of Medicine, Ohio.
Dronen
S C
SC
D000293:Adolescent; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012540:Scapula; D012783:Shoulder Dislocation / Q000628:therapy*