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An Improvised Reduction Method for Anterior Shoulder Dislocation in a Waterborne Environment.

Matthew J Christensen1, Thomas Renner1, William Bianchi1

  • 1Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, CA, USA.

Wilderness & Environmental Medicine
|March 17, 2025
PubMed
Summary

This case study presents a novel in-water technique for reducing anterior shoulder dislocations, particularly useful in aquatic environments. The improvised maneuver successfully treated a surfer in high surf when traditional methods failed due to lack of leverage.

Keywords:
glenohumeral dislocationocean rescueshoulder dislocation reductionsurf rescuewilderness medicine

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Area of Science:

  • Orthopedic Surgery
  • Emergency Medicine
  • Sports Medicine

Background:

  • Anterior glenohumeral joint (shoulder) dislocations are frequent orthopedic injuries.
  • Effective and timely reduction is crucial to prevent long-term complications.
  • Conventional reduction techniques often rely on mechanical advantage available on land.

Purpose of the Study:

  • To explore a novel, in-water prehospital technique for shoulder dislocation reduction.
  • To document the successful application of an improvised maneuver in a challenging aquatic environment.

Main Methods:

  • A case study involving a 36-year-old male surfer with an anterior shoulder dislocation.
  • Initial reduction attempts using standard techniques were unsuccessful due to the aquatic setting.
  • An improvised in-water reduction technique was implemented while the patient was afloat.

Main Results:

  • The novel in-water maneuver successfully reduced the anterior shoulder dislocation.
  • The technique was effective despite the lack of leverage typically available on land.
  • The patient's subsequent clinical course was favorable.

Conclusions:

  • This case report highlights a viable in-water technique for prehospital shoulder dislocation reduction.
  • The described maneuver offers a potential solution for neutral buoyancy or low-gravity environments.
  • This approach may be applicable when traditional methods are limited by the absence of gravity or friction.