Shoulder Reduction – Spanish-Style

Another interesting article regarding shoulder reduction techniques.

Essentially, what I read into shoulder reduction is that – if there many usually successful ways to do something, pretty much anything works.  And, what seems to be the generally accepted way to do it – excepting the scapular manipulation technique – is pulling on it.  What is different between methods seems to be how exactly you apply the traction.

This is a single-operator method with direct axial traction on the distal humerus with one hand and counter-traction on the acromium with the other hand.  The trouble I foresee with this method is that you’re fighting a lot of large muscles on the patient with your own, smaller, rotator cuff and shoulder abductors.  I think you’d end up fatiguing before a lot of your patients.

The variation I might suggest is the snowbird technique, where you use the weight of your leg to provide downward traction via stockinette around the forearm.  You can sometimes get away from having to do full procedural sedation if you can perform a technique like this where the patient fatigues before you do.

http://www.ncbi.nlm.nih.gov/pubmed/21620607