scholarly journals Reducing Shoulder by Vertical Traction: A One-Man Method for Shoulder Reduction

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Hayat Ahmad Khan ◽  
Younis Kamal ◽  
Mohammad Ashraf Khan ◽  
Munir Farooq ◽  
Naseemul Gani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Learning Curve ◽  
Shoulder Dislocation ◽  
Anterior Shoulder Dislocation ◽  
Greater Tuberosity ◽  
Traction Method ◽  
Joint Dislocations ◽  
Good Technique ◽  
Recurrent Shoulder Dislocation ◽  
Glenohumeral Dislocation

Fifty percent of joint dislocations reported to the emergency department are of shoulder joint. Various techniques are used to reduce the shoulder and Spaso technique is the least known to the orthopaedic residents which is a simple one-man vertical traction method of shoulder reduction. We evaluated the effectiveness of vertical traction method for anterior shoulder dislocation by orthopaedic residents. Sixty consecutive patients of anterior glenohumeral dislocation attending the emergency department of our hospital were taken up for the study. The reduction was done using Spaso technique. Right shoulder was dislocated in 40 patients and 31 patients had recurrent shoulder dislocation. In 55 patients, shoulder was reduced without the use of any anaesthesia. In patients where no anaesthesia was used, the time of traction ranged from 45 seconds to 5 minutes, while under anaesthesia the time of traction ranged from 1 to 4 minutes. Twenty-one patients had associated greater tuberosity fracture which did not affect the method of reduction and all of them were reducible. No complication was reported, and all the patients were satisfied with the method. In conclusion vertical traction method is a good technique for reducing anterior shoulder dislocation with an easy learning curve among the residents and no complication has been reported so far.

Inhaled methoxyflurane for the reduction of acute anterior shoulder dislocation in the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 468-472 ◽  
Author(s):  
Etimbuk Umana ◽  
Josephine Hannah Kelliher ◽  
Christiaan Johannes Blom ◽  
Brian McNicholl
Keyword(s):  
Emergency Department ◽  
Shoulder Dislocation ◽  
Recovery Time ◽  
Patient Flow ◽  
Hospital Setting ◽  
Anterior Shoulder Dislocation ◽  
Fracture Dislocations ◽  
Record Review ◽  
The Impact ◽  
Successful Reduction

ABSTRACTObjectivesMethoxyflurane is an inhalation analgesic used in the emergency department (ED) but also has minimal sedative properties. The major aim of this study was to evaluate the success rate of methoxyflurane for acute anterior shoulder dislocation (ASD) reduction. The secondary aim was to assess the impact of methoxyflurane on ED patient flow compared to propofol.MethodsA health record review was performed for all patients presenting with ASD who underwent reduction with either methoxyflurane or propofol over a 13-month period (December 2016 – December 2017). The primary outcome was reduction success for methoxyflurane, while secondary outcomes such as recovery time and ED length of stay (LOS) were also assessed compared to propofol. Patients with fracture dislocations, polytrauma, intravenous, or intramuscular opioids in the pre-hospital setting, no sedation for reduction, and alternative techniques of sedation or analgesia for reduction were excluded.ResultsA total of 151 patients presented with ASD during the study period. Eighty-two patients fulfilled our inclusion criteria. Fifty-two patients had ASD reduction with propofol while 30 patients had methoxyflurane. Successful reduction was achieved in 80% (95% CI 65.69% to 94.31%) patients who used methoxyflurane. The median recovery time and ED LOS were 30 minutes [19.3-44] and 70.5 minutes [49.3-105], which was found to be shorter for the methoxyflurane group, who had successful reductions compared to sedation with propofol.ConclusionMethoxyflurane was used successfully in 30% of the 82 patients undergoing reduction for ASD, while potentially improving ED efficiency.

scholarly journals The Efficacy of External Rotation Method for The Reduction of Acute Anterior Shoulder Dislocation With and Without Greater Tuberosity Fracture

2018 ◽  
Vol 3 (2) ◽  
pp. 408-412 ◽  
Author(s):  
Gopal Prasad Gnawali ◽  
Indra Dhakal ◽  
Kishor Khatri ◽  
Shanta Sharma
Keyword(s):  
Shoulder Dislocation ◽  
External Rotation ◽  
Reduction Process ◽  
Anterior Dislocation ◽  
Emergency Setting ◽  
Anterior Shoulder Dislocation ◽  
Greater Tuberosity ◽  
Rotation Method ◽  
Cause Of Failure ◽  
Successful Reduction

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.

scholarly journals A comparative study of the Milch method and the Spaso method in the reduction of anterior dislocation of the shoulder

2016 ◽  
Vol 3 (1) ◽  
pp. 92
Author(s):  
Chaitanya P. R. ◽  
Naveen P. R. ◽  
Kiran Kumar H. G.
Keyword(s):  
Comparative Study ◽  
Shoulder Dislocation ◽  
Anterior Dislocation ◽  
Anterior Shoulder Dislocation ◽  
Glenohumeral Dislocation

<p class="abstract"><strong>Background:</strong> The Milch and Spaso methods are used for reduction of anterior shoulder dislocation of the shoulder. This study was undertaken to compare the efficacy of these two methods<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Sixty patients with anterior glenohumeral dislocation were included in this study. 30 patients were reduced by each of the 2 methods and the efficacy and the pain experienced by the patient was studied.<strong></strong></p><p class="abstract"><strong>Results:</strong> Both methods were found to be equally efficacious. The pain felt by the patient was lower in the Milch method but this was not statistically significant<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Both the Milch and the Spaso methods are equally effective methods for reduction of anterior dislocation of the shoulder<span lang="EN-IN">.</span></p>

Biomechanical Effects of Failure Modes in Repeated Anterior Inferior Glenohumeral Joint Dislocations

2002 ◽  
Author(s):  
Thay Q. Lee ◽  
Bruce Y. Yang ◽  
James E. Tibnoe ◽  
Patrick J. McMahon
Keyword(s):  
Surgical Treatment ◽  
Shoulder Dislocation ◽  
Failure Modes ◽  
Glenohumeral Joint ◽  
Anterior Shoulder Dislocation ◽  
Joint Forces ◽  
Joint Dislocations ◽  
Precise Quantification

Accurate and precise quantification of the failure modes and repair methods for anterior inferior glenohumeral joint dislocations are very important for effective surgical treatment of the shoulder. The purpose of this study was to quantitatively assess the effects of failure modes and repair strength by measuring the differences in glenohumeral translation and joint forces prior to and following repeated anterior shoulder dislocation and repair.

scholarly journals Irreducible Anterior Shoulder Dislocation with Interposition of the Long Head of the Biceps and Greater Tuberosity Fracture: A Case Report and Review of the Literature

2017 ◽  
Vol 11 (1) ◽  
pp. 327-334 ◽  
Author(s):  
Konstantinos Pantazis ◽  
Andreas Panagopoulos ◽  
Irini Tatani ◽  
Basilis Daskalopoulos ◽  
Ilias Iliopoulos ◽  
...  
Keyword(s):  
Case Report ◽  
Shoulder Dislocation ◽  
Open Reduction ◽  
Biceps Tendon ◽  
Full Range ◽  
Successful Outcome ◽  
Anterior Shoulder Dislocation ◽  
Greater Tuberosity ◽  
Greater Tuberosity Fracture ◽  
Long Head

Background: Failure of closed manipulative reduction of an acute anterior shoulder dislocation is seldom reported in the literature and is usually due to structural blocks such as soft tissue entrapment (biceps, subscapularis, labrum), bony fragments (glenoid, greater tuberosity) and severe head impaction (Hill-Sachs lesion). Case report: We present a case of an irreducible anterior shoulder dislocation in a 57-year-old male patient after a road-traffic accident. He had severe impaction of the head underneath glenoid rim and associated fracture of the greater tuberosity. Closed reduction performed in the emergency room under sedation and later at the theatre under general anaesthesia was unsuccessful. Open reduction using the dectopectoral approach revealed that the reason for obstruction was the posterolateral entrapment of the biceps tendon between the humeral head and the tuberosity fragment. Reduction was achieved after subscapularis tenotomy and opening of the joint; the tuberosity fragment was fixed with transosseous sutures and the long head of the biceps tendon was tenodesized. The patient had an uneventful postoperative recovery and at his last follow up, 12 months postoperatively, he had a stable joint, full range of motion and a Constant score of 90. Conclusion: A comprehensive literature review revealed 22 similar reports affecting a total of 30 patients. Interposition of the LHBT alone or in combination with greater tuberosity fracture was the most common obstacle to reduction, followed by subscapularis tendon interposition and other less common reasons. Early surgical intervention with open reduction and confrontation of associated injuries is mandatory for a successful outcome.

Full recovery from a potentially lethal dose of orphenadrine ingestion using conservative treatment: A case report

2010 ◽  
Vol 29 (11) ◽  
pp. 961-963 ◽  
Author(s):  
Yan-Chiao Mao ◽  
Dong-Zong Hung ◽  
Chen-Chang Yang ◽  
Jiaan-Der Wang
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Conservative Treatment ◽  
Clinical Features ◽  
Shoulder Dislocation ◽  
Lethal Dose ◽  
Hemodynamic Instability ◽  
Toxic Effects ◽  
Anterior Shoulder Dislocation ◽  
Anticholinergic Effects

Intoxication by orphenadrine is uncommon. The clinical features consist of both central and peripheral anticholinergic effects. Ingestion of 2 to 3 g orphenadrine in an adult has been associated with fatality. A 46-year-old female was brought to our emergency department 1.5 hours after ingesting 40 tablets of 100 mg orphenadrine. She became stuporous 3 hours post-ingestion and developed generalized convulsions 1 hour later. Fifty-five hours post-ingestion, she had recovered and was found to have anterior shoulder dislocation. In addition, severe rhabdomyolysis and persistent nausea were observed. All of the above-noted toxic effects resolved with conservative treatment. Although orphenadrine intoxication can cause convulsions and hemodynamic instability, there is no available antidote and treatment remains supportive.

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