An alternative slump reduction technique of anterior shoulder dislocations: a 3-year prospective study.

OBJECTIVE

To describe an alternative method of dislocated shoulder reduction and to investigate its success rate when used at a ski resort setting.

DESIGN

A prospective observational study.

SETTING

Medical center at Australia's largest ski resort during the ski seasons of 1994, 1995, and 1996 (June through early October). The center is a primary care private practice.

PATIENTS: There were 199 patients with anterior dislocated shoulders who presented to the center. One patient was excluded from the study because of spontaneous reduction during clothing removal.

INTERVENTIONS: Patients had upper body clothing removed, were seated in a chair, and supported in a slumped position by an assistant. The medical officer then performed the reduction once relaxation was achieved. Patients were always offered Entenox (nitrous oxide).

MAIN OUTCOME MEASURES: Successful reduction of the anterior dislocated shoulder with or without analgesia. Any complications such as fractures and nerve damage were recorded.

RESULTS

The data were recorded by the treating medical officer. 93.2% of the subjects were successfully treated using the "slump" reduction method. The success rate on first attempt using the slump method was 85.6%. Of the remainder, four subjects were reduced by an alternative method and five were sent to hospital for reduction under general anesthesia. Four of these subjects had fractures.

CONCLUSION

The slump method of reduction for anterior dislocated shoulders compares favorably with previously documented methods. It would seem to be a particularly useful method when parenteral analgesia is either not available or relatively contraindicated. There were no complications resulting from the use of this method, and it is a method that is easy to learn. The slump method is a safe and effective addition to the primary care physician's options in reducing an anteriorly dislocated shoulder.