Rational shoulder dislocation reduction technique: a case series

Abstract

Shoulder dislocations are among the most frequent major joint dislocations encountered in emergency orthopedic practice, necessitating prompt intervention to alleviate pain, restore function, and prevent complications. Conventional reduction techniques often require multiple operators or procedural sedation and may involve high-force leverage maneuvers, which can increase the risk of iatrogenic injury. The “rational shoulder dislocation reduction technique” is a novel single-operator approach designed to address these challenges. This case series reports 12 patients with anterior, posterior, or inferior shoulder dislocations resulting from sports injuries, falls, and traffic accidents. Patients were treated using the Rational Technique, involving supine positioning, semi-physiological arm placement (30° abduction, 20° forward flexion, 90° elbow flexion), and gradual axial traction. General anesthesia was preferred when feasible; intra articular local anesthesia was used when general anesthesia was unavailable. The mean reduction time was 95 seconds, and all reductions were successful without complications. Post-reduction, a dedicated shoulder immobilizer was applied. This single-operator method is safe, reproducible, and practical for use in various clinical settings, including emergency departments, sports facilities, and resource-limited environments. Its simplicity and low-force approach make it a viable alternative to conventional techniques, reducing the need for multiple assistants and sedation while minimizing the risk of iatrogenic injury. Keywords: Shoulder dislocation, reduction technique, single-operator, axial traction, muscle relaxation, glenohumeral joint.