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.