Reduction of Shoulder Dislocation using Osteopathic Techniques without Anesthesia, A New Approach
Slabospitsky MA¹, Tkach AV², Tkachenko AN³, Maryam Jamil⁴ and Ehsan Ulhaq⁵*
¹State Budgetary Health Institution of Sevastopol "City Hospital No. 1 Named After N.I. Pirogova." St. Admiral Oktyabrsky, Sevastopol, Russia
²Crimean Federal University Named After V.I. Vernadsky, Simferopol, Lenin Boulevard, Russia
³North-Western State Medical University named after I.I. Mechnikov Ministry of Health of the Russian Federation, Saint-Petersburg, Russia
4Department of General Surgery Ghurki Trust Hospital, Lahore Medical and Dental College (LMDC) Lahore, Pakistan
5Department of Orthopedics Services Hospital Lahore, Services Institute of Medical Sciences (SIMS) Lahore, Pakistan
*Corresponding Author: Ehsan Ulhaq, Department of Orthopedics Services Hospital Lahore, Services Institute of Medical Sciences (SIMS) Lahore, Pakistan.
December 26, 2022; Published: January 05, 2023
Introduction: Among all joint dislocations, shoulder dislocation is most common. There are many ways to reduce a dislocated shoulder. Assistance to such victims is provided in ER, outpatient and inpatient. The results of conservative treatment of patients with shoulder dislocation are not always positive.
Purpose of the Study: To analyze the results of the author's manual procedure for reduction of shoulder dislocation.
Materials and Methods: The study was conducted from 2013 till end of 2020, the location of the study was the trauma center of the "City Hospital No. 1 named after N.I. Pirogov." The inclusion criteria of patients was the primary dislocation of the shoulder, the diagnosis: "Closed traumatic dislocation of the shoulder" in total - 1968 patients. Exclusion criteria - secondary dislocation. Successful correction of shoulder dislocation on an outpatient basis was performed in 1,159 (58.9%) patients, after unsuccessful correction, 809 (41.1%) patients were hospitalized with shoulder dislocation. Patients on an outpatient basis were randomly divided into 2 groups: group 1 - patients (n = 1552) were reduced by traditional methods using local anesthesia, in group 2 patients (n = 416) the author's manual technique was used without local anesthesia. By gender, age and type of dislocation, patients of both groups did not differ statistically significantly.
Results: The use of osteopathic techniques was effective in 85% of cases (352 people), 64 people were hospitalized (15%). The effectiveness of using traditional methods with the use of local anesthesia was 52% (dislocation was reduced in 807 patients), the rest of the patients were treated in inpatients.
Conclusion: The use of the author's manual technique in patients with dislocated shoulder on an outpatient basis has a higher efficiency compared to traditional methods due to the fact that more patients receive care without hospital admission. In addition, this type of treatment is carried out without anesthesia, which also reduces the cost of treatment in this category of patients.
Keywords: Shoulder Dislocation; Dislocation; Anesthesia; Manual Techniques
- Mickewicz VA. “Shoulder joint. Dislocations and pain syndromes”. Publishing house "Medical Information Agency" (2016): 552.
- Enger M., et al. “Shoulder injuries from birth to old age: A 1-year prospective study of 3031 shoulder injuries in an urban population”. Injury7 (2018): 1324-1329.
- Hawi N., et al. “Schulterluxationen des älteren Patienten [Shoulder dislocations in elderly patients]”. Unfallchirurg2 (2018): 126-133.
- Hettrich CM., et al. “Epidemiology of the Frequency, Etiology, Direction, and Severity (FEDS) system for classifying glenohumeral instability”. Journal of Shoulder and Elbow Surgery 1 (2019): 95-101.
- Galvin JW., et al. “The Epidemiology and Natural History of Anterior Shoulder Instability”. Current Reviews in Musculoskeletal Medicine 4 (2017): 411-424.
- Longo UG., et al. “Management of primary acute anterior shoulder dislocation: systematic review and quantitative synthesis of the literature”. Arthroscopy 4 (2014): 506-522.
- Kasmaee VM., et al. “Remifentanil versus propofol/fentanyl combination in procedural sedation for dislocated shoulder reduction; a clinical trial”. Archives of Academic Emergency Medicine 7 (2019): e10.
- Neviaser AS., et al. “Open Bankart repair for revision of failed prior stabilization: outcome analysis at a mean of more than 10 years”. Journal of Shoulder and Elbow Surgery 24 (2015): 897-901.
- Hurley ET., et al. “Long-term outcomes of the Latarjet procedure for anterior shoulder instability: a systematic review of studies at 10-year follow-up”. Journal of Shoulder and Elbow Surgery 28 (2019): e33-39.
- Bondarev VB., et al. “Shoulder dislocations”. Journal Emergency Medical Care1 (2020): 68–84.
- Мonica J., et al. “Acute shoulder injuries in adults”. American Family Physician 2 (2016): 119-127.
- Inui H., et al. “Glenoid osteotomy for patients with atraumatic shoulder instability”. Journal of Shoulder and Elbow Surgery 4 (2017): e110.
- Furuhata R., et al. “Risk factors for failure of reduction of anterior glenohumeral dislocation without sedation”. Journal of Shoulder and Elbow Surgery 2 (2021): 306-311.
- Theivendran K., et al. “Closed reduction methods for acute anterior shoulder dislocation”. European Journal of Trauma and Emergency Surgery 2 (2021): 407-421.
- Boffano M., et al. “Management of the first episode of traumatic shoulder dislocation”. EFORT Open Reviews 2 (2017): 35-40.
- Polyzois I., et al. “Traumatic First Time Shoulder Dislocation: Surgery vs Non-Operative Treatment”. The Archives of Bone and Joint Surgery 2 (2016): 104-108.
- Anjum R., et al. “Reducing shoulder dislocation without anaesthesia or assistant: Validation of a new reduction manoeuvre”. Chinese Journal of Traumatology 5 (2019): 274-277.
- Ullah I., et al. “Management of Shoulder Dislocation by Prakash Method”. Journal of Gandhara Medical and Dental Science 1 (2021): 21-24.
- Patent for an invention. Saint Petersburg - 2021. Pat. RU 2767685 C1 Russian Federation, IPC A61N 23/00. Method of treatment of closed dislocation of the humerus. Tkachenko A.N., Slabospitsky MA., et al. “Mechnikov Federal State Medical University of the Ministry of Health of the Russian Federation.
- Bock J., et al. “The arthroscopic Bankart repair procedure enables complete quantitative labrum restoration in long-term assessments”. Knee Surgery, Sports Traumatology, Arthroscopy 12 (2018): 3788-3796.
- Walz DM., et al. “Imaging of shoulder instability”. Seminars in Musculoskeletal Radiology 3 (2015): 254-268.
- Sodl JF., et al. “Biomechanical effects of anterior capsular plication and rotator interval closure in simulated anterior shoulder instability”. Knee Surgery, Sports Traumatology, Arthroscopy 2 (2016): 365-373.
- Tabatabaei S., et al. “Results of Magnuson-stack operation in recurrent anterior shoulder instability”. Pakistan Journal of Medical Sciences 4 (2010): 805-808.
- Ruiz Ibán MA., et al. “Instability severity index score values below 7 do not predict recurrence after arthroscopic Bankart repair”. Knee Surgery, Sports Traumatology, Arthroscopy 12 (2019): 3905-3911.
- Matveev RP and Aslanov VA. “New steps in the conservative treatment of primary traumatic dislocation of the shoulder”. Doctor Postgraduate43 (2012): 213-217.
- Voos JE., et al. “Prospective evaluation of arthroscopic Bankart repairs for anterior instability”. American Journal of Sports Medicine 2 (2010): 302-307.
- Alkaduhimi H., et al. “A systematic and technical guide on how to reduce a shoulder dislocation”. Turkish Journal of Emergency Medicine 4 (2016): 155-168.
- Gombera MM and Sekiya JK. “Rotator cuff tear and glenohumeral instability”. A Systematic Review in Clinical Orthopaedics and Related Research8 (2014): 2448-2456.
- Stafylakis D., et al. “Reducing a Shoulder Dislocation Without Sweating. The Davos Technique and its Results. Evaluation of a Nontraumatic, Safe, and Simple Technique for Reducing Anterior Shoulder Dislocations”. Journal of Emergency Medicine 4 (2016): 656-659.
- Sayegh FE., et al. “Reduction of acute anterior dislocations: A prospective randomized study comparing a new technique with the Hippocratic and Kocher methods”. Journal of Bone and Joint Surgery America 12 (2009): 2775-2782.
- Campagne D., et al. “Prehospital Traction Splint Use in Midthigh Trauma Patients”. Journal of Emergencies, Trauma, and Shock 4 (2020): 296-300.
- Kuru T., et al. “No Sedation, No Traction, and No Need for Assistance: Analysis of New Prakash's Method of Shoulder Reduction”. Emergency Medicine International (2020): 4379016.