Glenoumeral dislocation: a prospective randomized study comparing spazo and kocher maneuvers

Abstract

OBJECTIVE: To evaluate and to compare the Spaso and Kocher reduction maneuvers in terms of efficiency, time of reduction, facileness, pain, discomfort to the patient, complications and risks, besides promoting the comparison between the two maneuvers, aiming to ground the emergency conduct. METHODS: A prospective study with 105 patients with acute shoulder dislocations were enrolled in the study between February 2011 and September 2012. The patients were randomized into two groups and they were submitted to the reduction of dislocation using the Spaso maneuver (group A) or the Kocher technique (group B) by first, second or third-year orthopedic surgery residents from our service. The results were evaluated and compared. RESULTS: There was no statistically significant difference between the two groups in terms of age, gender, timing of reduction, number of precedent episodes and complications after reduction. However, reduction was achieved in more cases using the Spaso method than it was among the Kocher group, as well as the mean duration of the reduction maneuver and discomfort were shorter in the group A patients. CONCLUSIONS: Both methods presented good results in terms of dislocation reduction and low complications rates. Nevertheless, the Spaso maneuver was more efficient, fast and easily applicable in comparison with Kocher's method. Level of Evidence I, Therapeutic.

A comparative study of the Milch method and the Spaso method in the reduction of anterior dislocation of the shoulder

“…14,30,31 Both the Spaso and the Milch method are relatively atraumatic and do not need anaesthesia. 14,28,32 In the present study we have used both these methods for reduction and the percentage of successful reduction is comparable to various studies done using the Spaso method or the Milch method. [24][25][26][27]32 Even after an extensive review of literature we could not find a comparative study between these two methods.…”

“…24,25,27,28 This study was undertaken to compare the efficacy of Spaso and Milch technique in reduction of shoulder dislocation.…”

Reducción de la luxación glenohumeral anteroinferior aguda en el sistema de salud de la Argentina. Perspectiva nacional

“…1 El mecanismo habitual de lesión es una combinación de abducción, rotación externa y extensión. 7 Se han descrito y utilizado numerosas técnicas y maniobras de reducción para el tratamiento de estas luxaciones, entre las más difundidas en nuestro medio, se pueden mencionar: Kocher, [7][8][9] Stimson, 10 método hipocrático, 10 Spaso, 7 Milch, 10 FARES 10,11 y tracción/contratracción. 11 La pronta reducción y una maniobra correcta son esenciales para prevenir complicaciones vasculares, neurológicas o fracturas.…”