Use of the Scapular Manipulation Method to Reduce an Anterior Shoulder Dislocation in the Supine Position☆,☆☆,★
Section snippets
INTRODUCTION
Anterior shoulder dislocations are commonly seen after blunt trauma and are the most common of all dislocations seen in American emergency departments.1 Several methods exist for reducing anterior shoulder dislocations. Some methods require that the patient lie supine (the traction-countertraction technique2, the Kocher procedure3, the Hippocratic maneuver2, external rotation4, and the Milch-Cooper method5); others require the prone or sitting position (scapular manipulation6, the Stimson
CASE REPORT
A 30-year-old man was transported to our ED by paramedics after he was struck by a small truck when he ran into the street to rescue his cat. He was thrown into a group of bushes at the roadside, where he was found by paramedic personnel. On presentation to the ED, the patient complained of severe pain in his right shoulder and in his left lower abdomen. He denied any loss of consciousness but admitted to confusion at the scene of the accident. He reported a history of recurrent right shoulder
DISCUSSION
Anterior shoulder dislocation is the most commonly seen dislocation in emergency medicine.1 Several techniques have been developed to reduce such injuries and have been extensively reported.2, 3, 4, 5, 6, 7 The scapular manipulation method has been shown to be both efficacious and relatively painless6, 8, and it often can be performed without the use of sedation or analgesia.8 Our patient had to remain supine because of the possibility of an undetected cervical spine injury. Previous techniques
References (8)
- et al.
External rotation method of shoulder dislocation reduction
JACEP
(1979) - et al.
Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations
Ann Emerg Med
(1992) Reduction of anterior shoulder dislocations by scapular manipulation
Ann Emerg Med
(1993)- et al.
Closed reduction of anterior subcoracoid shoulder dislocation
Orthop Rev
(1986)
Cited by (17)
Shoulder Dislocations in the Emergency Department: A Comprehensive Review of Reduction Techniques
2020, Journal of Emergency MedicineCitation Excerpt :McNamara described this in the seated position by having a second clinician perform traction in forward flexion with 1 hand pulling the patient's arm forward while the other hand applies a counterforce at the clavicle to stabilize the patient's chest (112). Doyle and Ragar described this in the supine position with 1 clinician elevating the extremity in 90° of forward flexion (117). Another approach, the single-operator scapular manipulation and traction-countertraction (SOSMAT), has also been described (118).
A systematic and technical guide on how to reduce a shoulder dislocation
2016, Turkish Journal of Emergency MedicineCitation Excerpt :Thereafter the practitioner pushes the tip of the inferolateral scapular edge medially rotating upward, initiating the reduction (Fig. 15). This technique can be modified by having the patient in supine or seated position.55–57 This variation combines the Stimson's maneuver and the scapular manipulation technique; Stimson's maneuver is tried first, if that fails the scapular manipulation technique is added.58
Fracture Reduction and Splinting Techniques
2008, Pediatric Emergency MedicineFracture Reduction and Splinting Techniques
2007, Pediatric Emergency MedicineAnterior shoulder dislocations: Beyond traction-countertraction
2004, Journal of Emergency MedicineCitation Excerpt :Scapular manipulation is performed with slight traction on the affected arm, which is held in forward flexion at the shoulder to 90°. This may be accomplished with the patient prone, seated, or in the supine position (provided that the patient is positioned with the scapula exposed) (7,12,13). Most operators find this technique easier to perform in the prone or seated positions.
Acute complications associated with shoulder dislocation at an academic Emergency Department
2003, Journal of Emergency Medicine
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From the Department of Emergency Medicine, Providence Yakima Medical Center, Yakima, Washington.
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Address for reprints: William L Doyle, MD, Providence Yakima Medical Center, 110 South Ninth Avenue, Yakima, Washington 98902, 509-575-5060
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Reprint no. 47/1/69557