title: Reduction of Acute Shoulder Dislocations in a Remote Environment: A Prospective Multicenter Observational Study.
abstract: OBJECTIVE
  Acute dislocations of the glenohumeral joint are common in wilderness activities. Emergent reduction should take place at the site of trauma to reduce the patient's pain and the risk of vascular and neurological complications. A limited number of reduction methods are applicable in remote areas. The aim of this study is to present our method of reduction of anterior shoulder luxation that is easily applicable in remote areas without medication, adjuncts, and assistants and is well tolerated by patients.
  
  
  METHODS
  A prospective observational study was conducted during a 5-year period. The patients included underwent closed manual reduction with our technique. After each reduction, the physician who performed the reduction completed a standardized detailed history, and reexamined the patient (for acute complications). The patients were contacted 6 months after the trauma to investigate long-term postreduction complications.
  
  
  RESULTS
  Reduction was achieved with our method in 39 (100.0%) of 39 patients. The mean pain felt during our reduction procedure was rated 1.7 ± 1.4 (on a scale of 10) using the visual analog scale scoring system. No complications were noted before or after the reduction attempts. We did not find any long-term complications.
  
  
  CONCLUSIONS
  The reduction method presented in the present study is an effective method for the reduction of acute shoulder luxations in remote places. Our data suggest that this method could be applied for safe and effective reduction of shoulder dislocation.
authors.affiliation: Department of Thoracic Surgery, University Hospital Freiburg, Freiburg, Germany (Dr Bokor-Billmann). Electronic address: franck.billmann@wanadoo.fr.
authors.forename: Therezia
authors.initials: T
authors.lastname: Bokor-Billmann
authors.affiliation: Department of Thoracic Surgery, University Hospital Freiburg, Freiburg, Germany (Dr Bokor-Billmann).
authors.forename: Hryhoryi
authors.initials: H
authors.lastname: Lapshyn
authors.affiliation: Mediface Praxisklinik, Baden Baden, Germany (Prof Kiffner).
authors.forename: Erhard
authors.initials: E
authors.lastname: Kiffner
authors.affiliation: Department of Surgery, University Hospital Freiburg, Freiburg, Germany (Drs Lapshyn, Goos, Billmann and Prof Hopt).
authors.forename: Matthias F
authors.initials: MF
authors.lastname: Goos
authors.affiliation: Department of Surgery, University Hospital Freiburg, Freiburg, Germany (Drs Lapshyn, Goos, Billmann and Prof Hopt).
authors.forename: Ulrich T
authors.initials: UT
authors.lastname: Hopt
authors.affiliation: Department of Surgery, University Hospital Freiburg, Freiburg, Germany (Drs Lapshyn, Goos, Billmann and Prof Hopt).
authors.forename: Franck G
authors.initials: FG
authors.lastname: Billmann
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012783:Shoulder Dislocation / Q000628:therapy*; D055813:Wilderness Medicine / Q000379:methods*; D055815:Young Adult
keywords: painless; reduction; remote place; shoulder dislocation; wilderness