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August 2011- Relocation Technique Review: Kocher’s Method
Kocher was a pioneer in shoulder relocation, and in his 1870 article (translated here) he describes the techniques available in his day. He looks at the pros and cons of each method, discusses the use of traction, and whether analgesics were needed (he states that chloroform actually makes it harder!). To look at the key points of his article, click here.
It is worth noting that Kocher did not advocate the use of analgesics or traction.
X-ray of the month
Take a quick look at our X-ray of the month. It’s an unusual injury, with a fancy name.
Can you guess what the injury is? How would you treat it?
This year Dr Neil Cunningham gave a talk at the International Conference in Emergency Medicine, held in Dublin, Ireland. The talk was successful and well received, and the powerpoint presentation and talk are available on our Videos page, or on our Youtube channel. Unfortunately, the popularity led our hosting service to believe we had a virus and they shut the Shoulder Dislocation.net website down! After several months, we are pleased to report we are back up and running on a new dedicated server, thanks to Mike Cadogan and the team at Global Medical Education Project (GMEP). Anyway, we hope you enjoy the talk and presentation and look forward to the next year full of exciting updates.Read story
ShoulderDislocation.net has posted two new videos on our YouTube channel and Videos page. These videos are quite a bit different from the others - in that things didn't quite go as smoothly as we would have hoped. In both of these shoulder dislocations the relocation was proving to be a little difficult and might prompt abandonment of the techniques in favour of heavier sedation. The first video shows a patient with in whom the muscle spasm was unable to be overcome with simple positioning and a variety of manoeuvres. She eventually required sedation resulting an a quick reduction In the second video, the patient has a subglenoid dislocation, and the operator tries to get the patient to adduct the arm. Unfortunately this is difficult, so Neil talks the operator through a series of manoeuvres to manipulate the humerus into the correct position, including attempting Zero Position. Eventually the shoulder is relocated.Read story