New Shoulder Reduction – The “Elbow” Technique

January 25, 2019

 Written by Vivian Lei

Spoon Feed
The “elbow technique” is a simple and effective way to reduce anterior shoulder dislocations in this study.

Why does this matter?
Who doesn’t want another way to pop a shoulder back into place?

Add another shoulder reduction method to your arm-amentarium
In the study, 26 out of 26 emergency department patients with anterior shoulder reductions were successfully reduced with the elbow technique. The mean time for reduction was 5 seconds (range 3–69 s). No iatrogenic fractures or neurovascular injuries were reported after the reductions. 24 of the 26 patients received sedation prior to reduction with thiamylal sodium.

So how is it done?
The patient is placed in a supine position, and the operator stands on the side of the affected shoulder. The operator holds the wrist of the patient with his outer hand and applies a gentle traction force to keep the elbow straight (B, straight arrow), lifting to 45 degrees of forward flexion and abduction. With the lateral surface of the operator’s elbow, force is exerted on the midshaft of the patient’s humerus (D, straight arrow). By lengthening the lever arm (d), the force moment is increased, allowing the humeral head to glide back into the glenoid fossa more easily. (E) The reduction force pushes the humeral head posteriorly, superiorly, and laterally into the glenoid.

Source
The Elbow Technique: A Novel Reduction Technique for Anterior Shoulder Dislocations. J Emerg Med. 2018 Dec 6. pii: S0736-4679(18)31044-8. doi: 10.1016/j.jemermed.2018.10.018. [Epub ahead of print]

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Reviewed by Clay Smith