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A systematic comparison of the closed shoulder reduction techniques.
H Alkaduhimi1, J A van der Linde1, N W Willigenburg1
1Shoulder and Elbow Unit, Joint Research, OLVG, Oosterpark 9, Amsterdam, 1091 AC, The Netherlands.
Archives of Orthopaedic and Trauma Surgery
|March 3, 2017
Summary
Scapular manipulation is the most effective technique for closed shoulder reduction, offering high success rates, quick application, and minimal pain. The FARES method is a viable alternative for shoulder instability treatment.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Emergency Medicine
Background:
- Shoulder instability is a common orthopedic condition.
- Closed reduction is the initial treatment for anterior shoulder dislocations.
- Optimal reduction techniques require evaluation for efficacy and patient comfort.
Purpose of the Study:
- To determine the best closed reduction technique for shoulder instability.
- To compare techniques based on success rates, reduction time, pain, and complications.
Main Methods:
- Systematic literature search of PubMed and EMBASE.
- Inclusion of studies in English, Dutch, German, and Arabic detailing success rates.
- Quality assessment using the modified Coleman Methodology Score (CMS) and meta-analysis.
Main Results:
- Scapular manipulation: 97% success, 1.75 min reduction time, VAS 1.47 pain.
- FARES method: 92% success, 2.24 min reduction time, VAS 1.59 pain.
- Traction-countertraction: 95% success, 6.05 min reduction time, VAS 4.75 pain.
Conclusions:
- Scapular manipulation is the superior technique for closed reduction of anterior shoulder dislocations.
- The FARES method presents a strong alternative with comparable outcomes.
- Technique choice impacts patient outcomes, pain, and procedure duration.
