Reducing a Shoulder Dislocation Without Sweating. The Davos Technique and its Results. Evaluation of a Nontraumatic, Safe, and Simple Technique for Reducing Anterior Shoulder Dislocations

Stafylakis, Dimitrios; Abrassart, Sophie; Hoffmeyer, Pierre

doi:10.1016/j.jemermed.2016.01.020

Cited by 15 publications

(15 citation statements)

References 6 publications

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“…This technique has consistently been found to have an improving success rate with the most recent being 77% 10–12. This is comparable to other reduction methods (notably the Milch technique, 82–89%) 11. The only requirements are a conscious patient, an elastic bandage, and an assistant.…”

Section: Discussionmentioning

confidence: 65%

“…It can be particularly useful to those patients with a risk of recurrence or in remote locations with no immediate access to a hospital 12. A caveat to the implementation of this technique is that it requires a high degree of communication between practitioner and patient as well as compliance from the patient 11. Below are the steps to perform the Davos technique as originally described by Boss et al…”

Section: Discussionmentioning

confidence: 99%

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No Sweat! Bilateral Shoulder Reduction Using a Modified Davos Technique

Joseph

Nguyen

Gruzman

et al. 2019

Clinical Practice and Cases in Emergency Medicine

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Shoulder dislocations are a common entity seen and treated in the everyday practice of emergency physicians. Bilateral simultaneous shoulder dislocations, however, are rare and are only described in the literature through case reports with no consensus about how to effectively and efficiently reduce them. We present a case of a 21-year-old male who sustained bilateral simultaneous anterior shoulder dislocations after a suspected seizure. Following confirmation with radiographs, the patient’s dislocations were reduced successfully and in a timely manner using a novel method: the modified Davos technique.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

No Sweat! Bilateral Shoulder Reduction Using a Modified Davos Technique

Joseph

Nguyen

Gruzman

et al. 2019

Clinical Practice and Cases in Emergency Medicine

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“…Little information concerning the success rate of this reduction technique can be found in the literature, although the original paper reported it to be 60% 16 , 25 . It was also found to be the most successful technique for reducing subcoracoid anterior dislocations (84.5% success rate) and in patients under 40 years of age (85.3% success rate) 22 , 25 . However, we are not aware of any prospective randomized study on this procedure.…”

Section: Methodsmentioning

confidence: 92%

“…Patients who met the inclusion criteria and agreed to participate were randomly allocated to either the Sp group, in which the emergency department physician performed the reduction process with the Spaso technique 21 , or the BHM group, in which self-reduction with the Boss-Holzach-Matter technique 16 (Davos 22 or Aronen method) was performed by the patient under the guidance of the emergency department physician. Oral consent to participate was accepted prior to randomization given the difficulty of obtaining written consent, especially if the dominant arm was affected.…”

Section: Methodsmentioning

confidence: 99%

Teaching Patients How to Reduce a Shoulder Dislocation

Marcano-Fernández

Balaguer‐Castro

Fillat-Gomà

et al. 2018

The Journal of Bone and Joint Surgery

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Background: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.Methods: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.Results: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).Conclusions: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.Level of Evidence:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

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“…4 Further studies reported success rates up to 86%, with very low complication rates. 6 , 22 , 27 Notwithstanding the potential benefits and advantages of this technique, studies with a high level of evidence are missing to compare its effectiveness and safety with other conventional techniques.…”

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confidence: 99%