The scapular manipulation method for reducing anterior shoulder dislocations.

Anterior dislocation of the shoulder is the most common dislocation encountered by the emergency room medical officer. Many of the present methods employed, such as Kocher's method, the Hippocratic method and distraction method, necessitate the use of both intravenous pethidine and midazolam, which prolongs the recovery time of the patient in the emergency room, as well as carrying the risk of respiratory depression. Also, such methods are associated with complications such as fractures of the humerus and injury to the axillary vessels and brachial plexus. In view of the above disadvantages, an alternative method of reducing anterior shoulder dislocations was introduced to our emergency room medical officers. For a period of 9 months, the Accident and Emergency Department of Toa Payoh Hospital assessed the method of scapular manipulation for reducing anterior shoulder dislocations. This was a descriptive study. The method was found to have a high success rate (78.4%), was easy to teach, did not rely on the use of strong intravenous sedative agents, and was free of complications. Our experience with this method compared favourably with that of another large series which had a success rate of 79%.