Self-reduction techniques taught via smartphone are effective for anterior shoulder dislocation: prospective...

Area of Science:

• Orthopedic surgery
• Emergency medicine
• Musculoskeletal disorders

Background:

• Anterior shoulder dislocation is a common injury, particularly in young adults.
• Patients frequently present to emergency departments for shoulder reduction.
• Self-assisted reduction techniques offer an alternative to professional medical assistance.

Purpose of the Study:

• To prospectively evaluate three self-assisted shoulder reduction techniques: Stimson, Milch, and Boss-Holtzach-Matter.
• To compare their effectiveness when demonstrated via smartphone video instructions.
• To assess patient outcomes including success rate, pain, satisfaction, and complications.

Main Methods:

• Patients with anterior shoulder dislocation were randomized to one of three reduction techniques.
• Instruction was provided via a smartphone video link for self-guided reduction attempts.
• Outcomes measured included reduction success, pain scores, patient satisfaction, and adverse events.

Main Results:

• The Boss-Holtzach-Matter (53%) and self-assisted Milch (55%) techniques showed significantly higher success rates compared to the Stimson method (16%).
• Mean pain scores decreased significantly post-reduction.
• Patient satisfaction with the reduction attempt was moderate, and no complications were reported.

Conclusions:

• The self-assisted Milch and Boss-Holtzach-Matter techniques are suitable for reducing anterior shoulder dislocations without medical intervention.
• These methods can be effectively taught using instructional videos and performed without prior experience.
• Smartphone-based instruction facilitates successful patient self-reduction.