@article{ddd.uab.cat:190756,
      author = {Marcano-Fernández, F. A.) and Balaguer Castro, Mariano) and
               Fillat Gomà, Ferran) and Ràfols-Perramon, Ona) and Torrens, C.)
               and Torner, Pere)},
       title = {Teaching Patients How to Reduce a Shoulder Dislocation},
     journal = {Journal of bone and joint surgery. American volume},
        year = {2018},
      volume = {100},
       pages = {375--380},
       month = {3},
    abstract = {There are many different techniques for reducing acute anterior
               dislocations of the shoulder, and their use depends on surgeon
               preference. The objective of this study was to compare the pain
               experienced by a patient performing a self-reduction technique
               with the pain felt during a reduction performed by a trained
               physician. The study was carried out at the emergency department
               of a tertiary referral center. Patients between 18 and 60 years
               of age with an acute anterior shoulder dislocation were randomly
               allocated into 2 groups. In 1 group the emergency doctor actively
               guided the reduction process with the Spaso technique (Sp group),
               and in the other group the patient used the Boss-Holzach-Matter
               (also known as Davos or Aronen) self-reduction technique (BHM
               group). The pain experienced by the patient during the reduction
               was recorded by means of a visual analogue scale (VAS) ranging
               from 0 to 10. Other recorded data included demographic
               characteristics, reduction time, and success rate. Of 378
               patients assessed for eligibility from May 2015 until February
               2017, 197 did not meet the inclusion criteria, 58 met exclusion
               criteria, 22 declined to participate, and 41 withdrew before
               randomization. Sixty acute anterior shoulder dislocations were
               randomized into the Sp group (n = 30) or the BHM group (n = 30).
               The BHM group experienced significantly less pain during
               reduction than the Sp group (p = 0.047), with mean pain scores of
               3.57 (standard deviation [SD] = 2.1]) and 5.26 (SD = 2.9),
               respectively. No significant difference between groups was found
               with respect to reduction time (105 seconds [range, 10 to 660
               seconds] in the Sp group and 90 seconds [range, 5 to 600 seconds]
               in the BHM group; p = 0.6) or success rate (67% and 77%,
               respectively; p = 0.39). The self-reduction technique results in
               less pain than, and is as efficient in achieving reduction of
               anterior shoulder dislocations as, the Spaso technique. These
               findings favor the use of the self-assisted method as an
               effective first-line treatment for shoulder dislocations seen in
               the emergency department as well as its use by patients with
               recurrent dislocation. Therapeutic . See Instructions for Authors
               for a complete description of levels of evidence.},
         doi = {10.2106/JBJS.17.00687},
         url = {https://ddd.uab.cat/record/190756},
}