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Evaluation of the scapulohumeral distraction technique for anterior shoulder dislocation: a randomized controlled
Georgios Kalinterakis1, Georgios Velivasakis1, Konstantinos Balaouras1
1Department of Trauma and Orthopedics, General Hospital of Rethymnon, Rethymnon, Greece.
Background:
Shoulder dislocation is a common injury presenting in the emergency department. Numerous methods have been described in the literature for glenohumeral reduction. These methods can be divided into 2 groups: traction maneuvers and the combination of traction with scapula manipulation techniques. In this article, we introduced a new maneuver for shoulder reduction, namely, the combination of traction with handling the scapula (scapulohumeral distraction [SHD]), and compare it to the Hippocratic technique (HT).
Materials And Methods:
A total of 96 patients with acute anterior shoulder dislocation were enrolled from November 2021 to September 2023. Eighty-seven patients, who met all inclusion criteria, were randomly assigned to one of the 2 groups (SHD or HT). We evaluated each method for success rate, time to relocation, complications over a follow-up of 1 month, and patients' satisfaction and pain level during the procedure.
Results:
Both methods had comparable success rates (SHD 95.3% vs. HT 93.2%, P = .833) while no complications where observed. However, SHD method required significantly less procedure time (P = .001). Moreover, patients in SHD group reported significantly less pain (P = .012) and greater satisfaction (P = .003) levels. Furthermore, when we assessed relocation time, pain, and patient satisfaction as a function of recurrence, there were no statistically significant differences between the 2 techniques. Similarly, the evaluation of relocation time for both techniques as a function of body mass index and age did not indicate statistically significant differences.
Conclusion:
The SHD technique represents a safe, anatomically based and simple method for shoulder reduction. It showed a statistically significant decrease in relocation time and pain, with patients reporting higher satisfaction rates compared with the classical Hippocratic technique. Nonetheless, there were no statistically significant differences between the 2 techniques in regard to their success rates.
