Comparison between traction-countertraction and modified scapular manipulation for reduction of shoulder dislocation.
OBJECTIVE
One of the most common joint dislocations presented to the emergency department (ED) is anterior shoulder dislocation (ASD). Various techniques for the treatment of this abnormality have been suggested. In this study, we evaluated the efficacy and success rate of modified scapular manipulation (MSM) as a painless procedure compared to traction-countertraction (TCT) for reduction of ASD.


METHODS
Patients with ASD who were presented to ED of Baqiyatallah Hospital, Tehran during 2011 were included. They were randomly divided into MSM group or TCT group and then pain at reduction, time of reduction, duration of hospitalization, and success rate were compared. In TCT group, reduction was performed using sedative and antipain medications.


RESULTS
Ninety seven patients (81.6% male) with a mean age of 34.15 years±13.48 years were studied. The reduction time between both groups showed a significant difference (470.88 seconds±227.59 seconds for TCT group, 79.35 seconds±82.49 seconds for MSM group, P<0.001). The success rate in MSM group in the first and second effort were 89% and 97% whereas 73% and 100% in the TCT group respectively (P<0.001).


CONCLUSIONS
It seems that the manipulation technique can be more successful than the TCT method at the first effort whilst the second effort has the opposite results. Also MSM can be safer, cheaper and more acceptable for patients than TCT as a standard traditional method.
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Mohammad-Reza
MR
Ghane
Seyed-Hamed
SH
Hoseini
Hamid-Reza
HR
Javadzadeh
Sadrollah
S
Mahmoudi
Amin
A
Saburi
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D012540:Scapula; D012783:Shoulder Dislocation / Q000517:prevention & control / Q000628:therapy*; D014143:Traction / Q000379:methods*