Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations

STUDY OBJECTIVE: To evaluate the speed, efficacy, and safety of the scapular manipulation technique in reducing acute anterior shoulder dislocations.

DESIGN: Prospective study.

SETTING: Urban emergency department with an annual census of 65,000 patients.

PARTICIPANTS: Forty-eight adult patients with acute anterior shoulder dislocation.

INTERVENTIONS: Patients had an initial neurovascular and radiographic evaluation performed. They were sedated with IV fentanyl and midazolam. The shoulder was reduced using the scapular manipulation technique. The patient was re-evaluated for any evidence of complication. The total dose of analgesic required and time to reduction were recorded.

RESULTS: The scapular manipulation technique was successful in 46 of 48 (96%) cases. The average time to reduction was 6.05 minutes, and no complications were detected. Average doses of 1.83 mg midazolam and 204 micrograms fentanyl were required for reduction.

CONCLUSION: The scapular manipulation technique is a very fast, effective, safe method of reducing anterior shoulder dislocations in the ED. [Kothari RU, Dronen SC: Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations.