The External Rotation Method for Reduction of Acute Anterior Shoulder Dislocation

Introduction: Several methods of reduction technique have been described for the anterior dislocation of shoulder but none technique is said to be ideal. The aim of this study was to show the efficacy of external rotation method which could be safe and painless method for the reduction of the acute anterior shoulder dislocation with or without fracture of the greater tuberosity and to search the cause of failure of reduction.Objective: Objective of this study was to assess the efficacy of the external rotation method for reduction of acute anterior shoulder dislocation and to find the cause of failure of reduction.Methodology: All cases of anterior dislocation encountered in emergency department reduced by external rotation method by consultant orthopedic surgeon using basic emergency setting for resuscitation were included in the study. Fifty cases of shoulder dislocation was treated by this method and prospective evaluation done with regard to type of dislocation, the effectiveness of the procedure in achieving reduction, the need for pre-medication, the ease of performing reduction and complication if any.Results: Out of 50 cases, successful reduction was achieved in 42 patients. Premedication was not required in 36 successful reduction. Average time of reduction was 2 minutes in 30 patients and 5 minutes in 8 patients. Four Patients complained severe pain during reduction process. This method was not successful in 8 patients 2 of whom had displaced greater tuberosity fracture.Conclusion: The external rotation method is reliable and safe method for the reduction of acute anterior shoulder dislocation which can be performed relatively with less pain for both subcoracoid and subglenoid dislocation provided there is no displaced fracture of the greater tuberosity. BJHS 2018;3(2)6: 408-412.

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External rotation method for reduction of acute anterior dislocation of shoulder

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v4i2.24583 ◽

2017 ◽

Vol 4 (2) ◽

pp. 39-43

Author(s):

Rojan Tamrakar ◽

Balakrishnan M Acharya ◽

Nabes Man Singh Pradhan ◽

Suman Kumar Shrestha

Keyword(s):

Shoulder Dislocation ◽

External Rotation ◽

Orthopaedic Surgeon ◽

Anterior Dislocation ◽

Anterior Shoulder Dislocation ◽

Greater Tuberosity ◽

Rotation Method ◽

Time Required ◽

Displaced Fracture ◽

Successful Reduction

Introductions: Many different techniques of reduction of acute anterior shoulder dislocation have been described. The aim of this study was to evaluate the effectiveness of external rotation method for reduction of acute anterior shoulder dislocation. Methods: Fifty-one patients with acute anterior shoulder dislocations with or without greater tuberosity fracture were reduced during a period from January 2013 to January 2015. The external rotation method was used as an initial reduction method performed by orthopaedic surgeon on call or residents. Data sheets completed by the orthopaedic surgeon on call or residents were evaluated with regard to 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. Results: There were 42 male and nine female patients between 18 to 78 years. Among 51 patients, 49 had successful reduction. No premedication was required in 33 patients who had a successful reduction, and the average time required for reduction in 23 patients was within two minutes whereas 20 patients reduced within five minutes. Only four patients reported severe pain during the process of reduction. The method was not successful in two patients with subcoracoid dislocation associated with displaced fracture of the greater tuberosity. Conclusions: External rotation method is reliable, safe, simple and relatively painless method for reduction of acute anterior shoulder dislocation.

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External Rotation and Abduction Bracing in the Management of First-Time Anterior Shoulder Dislocation: Letter to the Editor

The American Journal of Sports Medicine ◽

10.1177/0363546515597219 ◽

2015 ◽

Vol 43 (8) ◽

pp. NP23-NP24

Author(s):

Adnan Saithna ◽

Robert W. Jordan

Keyword(s):

Shoulder Dislocation ◽

External Rotation ◽

Anterior Shoulder Dislocation ◽

Letter To The Editor ◽

First Time

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Immobilization in external rotation combined with abduction reduces the risk of recurrence after primary anterior shoulder dislocation

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2014.01.018 ◽

2014 ◽

Vol 23 (6) ◽

pp. 759-766 ◽

Cited By ~ 31

Author(s):

Kamran Heidari ◽

Shadi Asadollahi ◽

Reza Vafaee ◽

Abbas Barfehei ◽

Hossein Kamalifar ◽

...

Keyword(s):

Shoulder Dislocation ◽

External Rotation ◽

Anterior Shoulder Dislocation ◽

Risk Of Recurrence

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Outcomes of the Latarjet Procedure in Recurrent Anterior Shoulder Instability due to Tramadol-Induced Seizure

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v7i2.7000 ◽

2021 ◽

Author(s):

Mohammadreza Guity ◽

Arvin Najafi ◽

Pejman Mansouri ◽

Nima Bagheri

Keyword(s):

Shoulder Instability ◽

Shoulder Dislocation ◽

External Rotation ◽

Treatment Method ◽

Anterior Shoulder Instability ◽

Anterior Shoulder Dislocation ◽

Latarjet Procedure ◽

Seizure Episode ◽

Time Of Operation ◽

Recurrent Anterior Shoulder Instability

Background: This study was aimed to evaluate the final results of surgical treatment (Latarjet procedure) in the recurrent anterior shoulder instability following episodes of tramadol-induced seizure. Methods: From January 2005 to March 2013, 47 patients with recurrent anterior shoulder dislocation after suffering a seizure episode following tramadol use underwent surgical procedure. There were 53 shoulders in 47 male patients (six had bilateral recurrent dislocations). The mean age of the patients at the time of operation was 24.7 years (ranging from 20 to 44 years). The average number of episodes of anterior shoulder dislocation before surgery was 16. Results: External rotation with the elbow at the side improved from 45.8 ± 9.3° (30°-60°) pre-operatively to 61.5 ± 7.8° (45°-90°) postoperatively (P < 0.001). Forward elevation also increased significantly post-operatively (P = 0.002). Mean pre-operative Rowe score was 28.41 ± 4.30 (30-85) which increased to 73.57 ± 8.40 post-operatively. The Western Ontario Shoulder Instability Index (WOSI) score decreased from 1352 ± 74 to 618 ± 46 (P < 0.0001). Conclusion: Correcting glenoid bone loss by Latarjet procedure combined, if necessary, with humeral head defect reconstruction could be a proper treatment method in patients experiencing recurrent anterior shoulder dislocation after idiosyncratic seizure reaction of tramadol.

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A simple innovative Chennai handshake technique for reducing anterior dislocation of shoulder joint: a community study of 60 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20174700 ◽

2017 ◽

Vol 3 (6) ◽

pp. 1084

Author(s):

Muhammad Thahir ◽

B. Suresh Gandhi ◽

Kalaivanan Kanniyan ◽

Shanmugasundaram .

Keyword(s):

Shoulder Joint ◽

Shoulder Dislocation ◽

External Rotation ◽

Care Center ◽

Tertiary Care ◽

Stage I ◽

Stage Ii ◽

Anterior Dislocation ◽

Vertical Oscillation ◽

Anterior Shoulder Dislocation

Background: Anterior shoulder dislocation is one of the commonest dislocation of our body. We here by introduce a simple, safe, successful and easily reproducible “Chennai Handshake Technique” to relocate anterior dislocation of shoulder joint.Methods: This method was performed by a single surgeon on sixty cases (51 males, 9 females) of anterior shoulder dislocation with a mean age of 38 years (18 to 58 years) between 2008 to 2013 in tertiary care center. Among sixty patients, there were 12 cases (20%) of fresh dislocation and 48 cases (80%) of recurrent dislocation. It comprises of holding the hand in a classical double shake position and then giving a gentle longitudinal traction (stage I) followed with slow abduction and external rotation of arm (stage II), thus reducing the shoulder dislocation. Vertical oscillation may be a part of stage II in some cases before the external rotation.Results: The index time of patient presenting to the casualty ranged from one hour to 18hrs with a mean of 4.45 hrs. The reduction time ranged from 1 to 16 min with a mean of 5.6 min. 17 dislocations (28.3%) were reduced during stage I. 41 dislocations (68.3%) were reduced during stage II. 5 dislocations (12.1%) needed vertical oscillation during stage II. we failed in two cases (3.3%).Conclusions: No need of assistant, no need of anesthesia, no complications makes this technique, a more look back one.

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Effectiveness of External Rotation Immobilization in Highly Active Young Men with Traumatic Primary Anterior Shoulder Dislocation or Subluxation

Orthopedics ◽

10.3928/01477447-20100722-07 ◽

2010 ◽

Cited By ~ 1

Author(s):

Yoshitaka Tanaka ◽

Kenji Okamura ◽

Tomohito Imai

Keyword(s):

Shoulder Dislocation ◽

External Rotation ◽

Young Men ◽

Anterior Shoulder Dislocation ◽

Highly Active

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Conservative management of first-time traumatic anterior shoulder dislocation

Obere Extremität ◽

10.1007/s11678-021-00626-z ◽

2021 ◽

Author(s):

Benedikt Schliemann ◽

Marvin Minkus ◽

Dominik Seybold ◽

Markus Scheibel

Keyword(s):

Conservative Management ◽

Shoulder Dislocation ◽

External Rotation ◽

Young Patients ◽

Clinical Results ◽

Current Evidence ◽

Anterior Shoulder Dislocation ◽

Recurrence Rates ◽

Traumatic Anterior Shoulder Dislocation ◽

First Time

AbstractTraumatic anterior shoulder dislocation is a common injury in young and active patients and the proper treatment is still a matter of debate. The recurrence rate after conservative management remains high and, therefore, primary surgical intervention is sometimes recommended in very young patients whose risk of recurrences is highest. Immobilization in external rotation, first described by Itoi, is a promising conservative option as it provides adequate labral reduction and low recurrence rates. Recent meta-analyzes could not unequivocally demonstrate its superiority over internal rotation immobilization. However, biomechanical and early clinical results show a better effect on reduction of the labrum and lower recurrence rates for immobilization in a combination of abduction/external rotation than for external rotation alone. The present article aims to provide an overview of the conservative management of first-time traumatic shoulder dislocation in order to provide the treating physician or surgeon with the best current evidence as a basis for developing the appropriate treatment strategy for the patient.

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