Reduction of acute anterior shoulder dislocations using the Milch technique: a study of ski injuries

J Trauma. 1981 Sep;21(9):802-4. doi: 10.1097/00005373-198109000-00009.

Abstract

During the 1977-78, 1978-79, and 1979-80 ski seasons, 76 acute anterior shoulder dislocations were treated by one of three Orthopedic Surgeons at the Rutland Vermont Hospital Emergency Room: 68 (89.4%) were reduced on first attempt using the Milch technique of abduction and external rotation. Four (5.2%) required general anesthesia and four were reduced using meperidine hydrochloride (Demerol, Winthrop) and diazepam (Valium, Roche) and a traction-countertraction technique. Of the 68 shoulders reduced with the Milch technique, 47 (69.1%) required no analgesics or muscle relaxants. There were no complications attributable to the technique itself. Males were injured more frequently than females in a 4.4:1 ratio. Left shoulder injuries were as common as right. Recurrent dislocations occurred more frequently in younger individuals. Fractures of the greater tuberosity were associated injuries in five (6.6%) of all dislocations. These all occurred in individuals older than age 39 years and were coincident with primary dislocations.

MeSH terms

  • Adult
  • Analgesia / statistics & numerical data
  • Anesthesia, General / statistics & numerical data
  • Athletic Injuries / therapy*
  • Female
  • Humans
  • Male
  • Methods
  • Muscle Relaxants, Central
  • Recurrence
  • Shoulder Dislocation / therapy*
  • Skiing*

Substances

  • Muscle Relaxants, Central