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Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations
1Department of Emergency Medicine, University of Cincinnati College of Medicine, Ohio.
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.