[Reduction of shoulder dislocation with the Cunningham method].

Area of Science:

• Orthopedics
• Emergency Medicine
• Sports Medicine

Background:

• The Cunningham technique is a recognized method for shoulder dislocation reduction.
• This technique theorizes that biceps tendon tension contributes to shoulder dislocation.
• Emergency department physicians at Landspitali University Hospital (LUH) were trained in the Cunningham method in 2013.

Purpose of the Study:

• To evaluate the impact of implementing the Cunningham technique in an emergency department.
• To assess changes in reduction attempts, success rates, sedation, analgesics, and patient length of stay.

Main Methods:

• Retrospective study analyzing patient data from LUH emergency department in 2012 and 2013.
• Data collected included patient demographics, ED length of stay, reduction methods, and medication use.
• Statistical analysis involved descriptive statistics, independent sample t-tests, and chi-square tests.

Main Results:

• The proportion of Cunningham technique use on first attempt increased from 1% to 27%.
• Average reduction attempts increased slightly (1.15 to 1.38), and first-attempt success decreased (81.6% to 66%).
• Overall successful relocation rates (93.1% to 97.1%) and ED length of stay (226 to 219 minutes) were not significantly different. Sedation ratios decreased significantly (85.1% to 73.8%).

Conclusions:

• Implementing the Cunningham technique significantly reduced the requirement for sedation in shoulder dislocation cases.
• The technique did not negatively impact overall successful relocation rates or emergency department treatment duration.
• Further research may explore optimizing the Cunningham technique for improved first-attempt success.