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

Author(s):  
Muhammad Thahir ◽  
B. Suresh Gandhi ◽  
Kalaivanan Kanniyan ◽  
Shanmugasundaram .

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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%).</p><p><strong>Conclusions:</strong> No need of assistant, no need of anesthesia, no complications makes this technique, a more look back one.</p>

2018 ◽  
Vol 3 (2) ◽  
pp. 408-412 ◽  
Author(s):  
Gopal Prasad Gnawali ◽  
Indra Dhakal ◽  
Kishor Khatri ◽  
Shanta Sharma

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.


2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Suraj Bidary ◽  
Suresh Pandey ◽  
Roshani Aryal ◽  
Prabal KC ◽  
Kushal Bhattarai ◽  
...  

Background: As documented in many studies, anterior shoulder dislocation can be effectively immobilized in both external and internal rotation positions, with favorable outcomes. However, controversy exists about the superiority of the technique of immobilization to achieve the reduced rate of redislocation. We conducted this study to assess the functional outcome of immobilization of shoulder in external rotation position after relocation in patients with acute anterior shoulder dislocation. Methods: This is hospital based cross-sectional study in total of 36 patients of primary anterior dislocation of shoulder. They were managed with closed reduction and immobilization in external rotation position and followed up for up to twelve months. Functional outcome (including re-dislocation rate) during each follow-up visit was assessed by using ROWE Score. Results: The mean age of the participants was 29.6±7.9 years (range: 17-44 years). Of them, 89.9% were male; and 55.6% were involved in risky jobs. Similarly, 50% of them sustained injury due to slip and fall, 72.2% presented to the hospital within 12 hours; and 69.4% had their right side involved. All the patients were compliant with treatment regime; 77.8% tolerated the brace well and the redislocation rate was 8.3%. ROWE score was found to be significantly increased between subsequent follow-up visits (p<0.05), except between six months and 12 months (p>0.05). Overall, ROWE score varied significantly across the total follow-up period (p<0.05). Conclusions: Immobilization in external rotation position in traumatic anterior shoulder dislocation was a simple and easy method of conservative treatment with good patient compliance, less incidence of re-dislocation and good functional outcome.


2017 ◽  
Vol 4 (2) ◽  
pp. 39-43
Author(s):  
Rojan Tamrakar ◽  
Balakrishnan M Acharya ◽  
Nabes Man Singh Pradhan ◽  
Suman Kumar Shrestha

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.  


Author(s):  
Ashish Devgan ◽  
Umesh Yadav ◽  
Rajesh Rohilla ◽  
Pankaj Sharma ◽  
Varun Goel ◽  
...  

<p class="abstract">Surgical procedures for recurrent anterior dislocation of the shoulder include using capsuloligamentous or bone blocks to create barriers and active interventions using muscle actions. Fracture of glenoid acts as a barrier for bone block procedures. Boytchev procedure, though outmoded, yet acts as simple and effective procedure in this condition. Here we report a 44 year old male with recurrent anterior dislocation with glenoid fracture treated by Boytchev procedure. The patient is on regular follow up since 3 years with no episode of shoulder dislocation till now with full range of movements. To conclude, Boytchev procedure is technically simple and effective method in patients with recurrent anterior shoulder dislocation with fracture of glenoid.</p>


2009 ◽  
Vol 91 (1) ◽  
pp. 2-7 ◽  
Author(s):  
Steven Cutts ◽  
Mark Prempeh ◽  
Steven Drew

INTRODUCTION Anterior dislocation of the shoulder is commonly seen in accident and emergency (A&E) and trauma clinics. In this article, we review the existing literature on the injury and the recent trends in management. MATERIALS AND METHODS We have discussed this condition with our colleagues and performed a Medline search (‘anterior shoulder dislocation’) of the relevant papers. We also describe key historical publications and recent developments regarding immobilisation of the joint. RESULTS Management decisions regarding this condition continue to vary between units, especially for recurrent and posterior dislocation. This paper lays some emphasis on the choice of analgesic agent when attempting shoulder reduction in the A&E setting. A summary of the data from our own department has provided a graphical representation of the classical age and sex distribution for this condition. CONCLUSIONS Shoulder dislocation is a common injury. Delays in diagnosis remain the single biggest obstacle to optimum results in this group of patients. A significant proportion will require eventual surgery and up to a third of these patients will go on to develop long-term shoulder arthritis. Even patients who have experienced a single episode of dislocation may go on to develop long-term sequelae.


2014 ◽  
Vol 23 (6) ◽  
pp. 759-766 ◽  
Author(s):  
Kamran Heidari ◽  
Shadi Asadollahi ◽  
Reza Vafaee ◽  
Abbas Barfehei ◽  
Hossein Kamalifar ◽  
...  

2021 ◽  
Vol 31 (03) ◽  
pp. 128-131
Author(s):  
Naveed Ali Shair ◽  
Aftab Anwar ◽  
Muhammad Kashif ◽  
Usman Nazir Gill ◽  
Shiraz Malik

Objective: To compare External Rotation Method with Milch method for reduction of acute anterior dislocation of shoulder joint. Study Design: Randomized controlled trial. Place and Duration: The Department of Orthopedic Surgery, Services Hospital Lahore, from May 2016  to December 2016. Materials and Methods: 110 patients of acute anterior dislocation of shoulder joint were randomly distributed into two groups. Reduction of shoulder joint was achieved with External Rotation Method in Group A while Milch method was employed in Group B and there outcomes were compared. Data was entered and analyzed using SPSS for windows (version 21). P-value < 0.05 was considered significant. Result: Statistical difference between success rate of External Rotation (72.7%) and Milch Method (74.5%), was insignificant (p=0.828) Conclusion: Though external rotation method is easy to perform, both methods can be used in reduction of acute anterior dislocation of shoulder joint.


Author(s):  
Mohammadreza Guity ◽  
Arvin Najafi ◽  
Pejman Mansouri ◽  
Nima Bagheri

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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