Scapula Manipulation Techniques

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Scapula Manipulation Techniques
Baykal B, Sener S, Turkan H. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department. Emerg Med J 2005; 22: 336–338. [EXPAND Abstract]

We report the successful use of SMT in the prone position for the reduction of traumatic anterior shoulder dislocations, mainly without requirement of any sedatives or opiate analgesics. We believe that SMT may also be applied by inexperienced physicians, as it is simple, applicable, and easily understood. As no single method has a 100% success rate, SMT is a useful one to know.[/EXPAND]

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Pishbin E, Bolvardi E, Ahmadi K. Scapular manipulation for reduction of anterior shoulder dislocation without analgesia: Results of a prospective study Emerg Med Aust 2011: 1374; 54..58. [EXPAND Abstract]

To the best of knowledge, this was the first study of scapular manipulation technique (SMT) in Asia. We conducted this prospective study to report our experiences of reducing anterior shoulder dislocation by SMT without analgesia in a large study group in Iran. We achieved a success rate of 87.5% without medication at the first attempt and 97.3% overall. In total, 98.2% of dislocations were reduced in less than 1 min. The success rate was significantly lower in the presence of greater tuberosity fractures and also in late presentations (>6 h after trauma). We showed a success rate of 100% in recurrent dislocations. Some 81.1% of the patients reported no pain or mild pain. No complications were observed.[/EXPAND]

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Doyle WL, Ragar T. Use of the scapular manipulation method to reduce an anterior shoulder dislocation in the supine position. Ann Emerg Med 1996; 27(1): 92-4. [EXPAND Abstract]

We report the successful use of the scapular manipulation method to reduce an anterior shoulder dislocation in a multiply traumatized patient in the supine position. We discuss the treatment options for multiply traumatized patients with anterior shoulder dislocations in whom cervical spine injury is a possibility. Although larger patient studies are necessary for confirmation, we show that in this particular case the scapular manipulation technique was safely employed. To our knowledge, this is the first reported case of use of the scapular manipulation method with the patient in the supine position. [/EXPAND]

Annals of Emergency Medicine
Kothari RU, Dronen SC. The scapular manipulation technique for the reduction of acute anterior shoulder dislocations. J Emerg Med 1990; 8(5): 625-8. [EXPAND Abstract]

Anterior shoulder dislocations are a common occurrence in busy emergency departments. Numerous techniques for treating this problem have been reported. The majority of these techniques use traction and leverage of the humerus, often requiring considerable force and causing significant patient discomfort. We report a simple, relatively painless, and atraumatic method of shoulder reduction involving manipulation of the scapula as well as the humerus. This technique has been used in our emergency department with considerable success and no complications.[/EXPAND]

Journal of Emergency Medicine
Shoukry K, Riou B. Anterior dislocation of shoulder: reduction in the emergency department by scapular rotation and humeral traction. Ann Emerg Med 2004; 44 Suppl 4: S128. [EXPAND Abstract]

We evaluate pain during the reduction procedure of an anterior dislocation of shoulder. Artl technique, which consisted of a scapular rotation and traction on the humerus, was performed without analgesia. This technique alleviates pain on resting the dislocated shoulder on the back of a seat without the use of analgesics. Rate of success is high (98%) even with associated fracture, inaugural dislocation, or prolonged dislocation time beyond 110 minutes.[/EXPAND]

Annals of Emergency Medicine

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