Abstract
BackgroundShoulder dislocations account for almost 50% of all joint dislocations, and are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the external rotation method (ERM) in the reduction of acute anterior shoulder dislocation.Materials and methodsBetween August 2006 and April 2007, ERM was applied to 31 patients who presented with traumatic anterior shoulder dislocation to the Emergency Department of our Hospital which is a level 2 trauma centre. We evaluated the type of dislocation, the effectiveness of the procedure in achieving reduction, the need for premedication, the ease of performing the reduction, and complications, if any.ResultsOf the 31 patients, 29 had a successful reduction. No premedication was required in 25 patients who had a successful reduction, and the average time required for reduction in 25 was less than 2 min. Only five patients reported severe pain during the process of reduction. The method was not successful in two patients in whom the reduction was achieved under narcosis. We experienced a success rate of 89% at the first attempt. None of the patients encountered any complication.ConclusionsERM for the reduction of acute anterior dislocation of the shoulder is a safe and reliable method, mainly without requirement for any sedatives or opiate analgesics, that can be performed relatively painlessly for anterior shoulder dislocations. As no single method has a 100% success rate, ERM is a useful one to know.
Highlights
Shoulder dislocations account for almost 50% of all joint dislocations presenting to emergency departments [1]
The external rotation method is a relatively new technique, which is reported to be safe, comfortable, and reliable [7]. This prospective study was conducted to report our experiences of using the external rotation method (ERM) to reduce traumatic anterior shoulder dislocations and to evaluate the causes of failure
Kuhn [8] presented the best available evidence to answer questions regarding the treatment of patients with an initial anterior shoulder dislocation, reporting that, of the many methods to reduce the dislocated shoulder, little data exist to identify the best method and that premedication with intra-articular lidocaine has fewer complications and requires a shorter time in the emergency room than intravenous sedation, with no detectable differences in reduction success rates
Summary
Shoulder dislocations account for almost 50% of all joint dislocations presenting to emergency departments [1]. The external rotation method is a relatively new technique, which is reported to be safe, comfortable, and reliable [7] This prospective study was conducted to report our experiences of using the external rotation method (ERM) to reduce traumatic anterior shoulder dislocations and to evaluate the causes of failure. Shoulder dislocations account for almost 50% of all joint dislocations, and are most commonly anterior (90–98%) and occur due to trauma This prospective study was conducted to report our experiences of using the external rotation method (ERM) in the reduction of acute anterior shoulder dislocation. Materials and methods Between August 2006 and April 2007, ERM was applied to 31 patients who presented with traumatic anterior shoulder dislocation to the Emergency Department of our Hospital which is a level 2 trauma centre. As no single method has a 100% success rate, ERM is a useful one to know
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