Efficacy of the assisted self-reduction technique for acute anterior shoulder dislocation.
BACKGROUND
The "original" traction-free Kocher's method to perform the reduction of shoulder dislocation has been recently reviewed and some authors speculated that it can be self performed by patients under the guide of the physician. In this way, as an "assisted self-reduction" technique, it is also effective and simple to perform. The aim is to study the effectiveness of the assisted self-reduction technique, in comparison to the well known and largely used traction-countertraction method.


METHODS
From a consecutive series of 237 uncomplicated anterior shoulder dislocations, a total of 61 were managed by the residents of our institution under the supervision of the senior authors using the assisted self-reduction method and 176 were managed by other orthopaedic consultants on duty in the Emergency Department using the traction-countertraction technique. Only the senior authors used the assisted self-reduction technique, whereas the other orthopaedic consultants used the traction-countertraction method. The need for intravenous sedation or general anaesthesia to perform the assisted self-reduction was considered a failure. Recorded variables were demographic data, previous dislocation, traumatic mechanism and medication use during shoulder reduction, time to perform the reduction.


RESULTS
Ninety-eight percent of the acute dislocation treated with the assisted self-reduction technique and 81 % treated with the traction-countertraction method were reducible without recourse to intravenous sedation.


CONCLUSIONS
The assisted self-reduction technique is simple, effective and gentle. Physicians on duty in the Emergency Departments should therefore be encouraged to use it.
Department of Orthopaedic and Traumatology, S. Andrea Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Via di Grottarossa 1035, 00189, Rome, Italy, francesco.turturro@gmail.com.
Francesco
F
Turturro
Antonello
A
Montanaro
Cosma
C
Calderaro
Luca
L
Labianca
Vincenzo
V
Di Sanzo
Alessandro
A
Carducci
Andrea
A
Ferretti
D000328:Adult; D000368:Aged; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D012648:Self Care; D012783:Shoulder Dislocation / Q000628:therapy*; D014143:Traction / Q000379:methods; D016896:Treatment Outcome