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.