Reduction of traumatic, primary anterior shoulder dislocations with local anesthesia

Suder, Piotr; Mikkelsen, J B; Hougaard, Kjeld; Jensen, Poul Ejnar

doi:10.1016/s1058-2746(09)80072-4

Cited by 21 publications

(51 citation statements)

References 12 publications

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“…The use of intraarticular analgesia in shoulder reduction has been shown in prospective randomised studies to be cost-effective and a safe procedure with fewer complications. 11,12 However, a prospective, randomised, non-blinded study to ascertain whether these results could be reproducible failed to show any statistical significant differences. 13 Given the evidence thus far, intra-articular analgesia is probably worth our consideration, especially in patients where parenteral analgesics or sedation is contra-indicated for other medical reasons.…”

Section: Survey Of the Management Of Acute Traumatic First-time Antermentioning

confidence: 99%

Survey of the Management of Acute Traumatic First-Time Anterior Shoulder Dislocation Among Trauma Clinicians in the UK

Chong

Karataglis

Learmonth

2006

annals

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INTRODUCTION The aim of this work was to survey how acute traumatic first-time anterior shoulder dislocation (AFSD) is managed among trauma clinicians in UK using a postal questionnaire.PATIENTS AND METHODS A total of 150 questionnaires were sent out to active consultant members of the British Trauma Society in the UK. Questions were laid out in two 'workgroups'. In Workgroup One, an assortment of questions was included regarding choices and methods of analgesia, methods of monitoring used, methods of reduction, and position of immobilisation. In Workgroup Two, three different case scenarios were analysed to look into the 'post-reduction' management. RESULTS The response rate was 60%. Of respondents, 22% have a local protocol for managing AFSD. Almost all respondents recommended pre-and post-reduction X-rays as standard practice. Most respondents favoured systemic analgesia and sedation with airways' monitoring, as opposed to intra-articular anaesthesia (68 versus 9). Eighty-four respondents advocated immobilisation in internal rotation compared to six in external rotation. Only 19% (16 of 84) of respondents would perform an immediate arthroscopic stabilisation in young, fit patients presenting with this type of injury.CONCLUSIONS This survey revealed variations among trauma clinicians in managing AFSD on the 'front-line'. There is a need to address the issue of intra-articular analgesia, immobilisation technique and management of AFSD in the young patient with regards to immediate surgical intervention. We suggest that these issues be revised and clarified, ideally in a randomised, controlled, clinical trial prior to the introduction of a protocol for managing this problem.

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Section: Survey Of the Management Of Acute Traumatic First-time Antermentioning

confidence: 99%

Survey of the Management of Acute Traumatic First-Time Anterior Shoulder Dislocation Among Trauma Clinicians in the UK

Chong

Karataglis

Learmonth

2006

annals

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“…Complications secondary to intra-articular injection of lidocaine was not seen in any of the studies by Kosnik et al ,5 Suder et al ,4 Lippitt et al 9 and Matthews and Roberts 10. Complications following intravenous injection in the aforementioned studies were 5%, 11%, 12%, and 30%, respectively; it should be noted that, except for the Suder study, none of the complications were reported to be severe 4 5 9 10.…”

Section: Discussionmentioning

confidence: 79%

“…Complications following intravenous injection in the aforementioned studies were 5%, 11%, 12%, and 30%, respectively; it should be noted that, except for the Suder study, none of the complications were reported to be severe 4 5 9 10. Cunningham has stated the possibility of joint infection following an intra-articular injection of lidocaine, which is not reported in any other study 11…”

Section: Discussionmentioning

confidence: 86%

“…Conversely, Lippitt et al showed a 100% success rate in the group who had received intra-articular lidocaine, and a 75% success rate in the group who received the intravenous drugs 9. Likewise, Suder et al stated a nearly similar success rate in the two groups (IV: 94%; IA: 97%) 4. Mathews and Roberts did not state any failure using either of the above mentioned medications 10…”

Section: Discussionmentioning

confidence: 88%

“…Intra-articular injection of lidocaine is one such alternative 4. Several studies have reported the pain relief following intra-articular administration of lidocaine as being similar to that achieved with intravenous morphine/diazepam or intravenous midazolam/fentanyl.…”

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confidence: 99%

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Intra-articular lidocaine versus intravenous meperidine/diazepam in anterior shoulder dislocation: a randomised clinical trial

Moharari

Khademhosseini

Espandar

et al. 2008

Emergency Medicine Journal

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Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals

Berendes

Pilot

Nagels

et al. 2015

Arch Orthop Trauma Surg

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IntroductionThe primary aim of this study was to record how orthopaedic surgeons are currently managing acute first-time anterior shoulder dislocation (AFASD) 8 years after introduction of the Dutch national guideline: “acute primary shoulder dislocation, diagnostics and treatment” in 2005. The second aim was to evaluate how these surgeons treat recurrent instability after AFASD.Materials and methodsAn online questionnaire regarding the management of AFASD and recurrent shoulder instability was held amongst orthopaedic surgeons of all 98 Dutch hospitals.ResultsThe overall response rate was 60 %. Of the respondents, 75 % had a local protocol for managing AFASD, of which 28 % had made changes in their treatment protocol after the introduction of the national guideline. The current survey showed wide variety in the overall treatment policies for AFASD. Twenty-seven percent of the orthopaedic surgeons were currently unaware of the national guideline. The variability in treatment for AFASD was present throughout the whole treatment from which policy at the emergency department; when to operate for recurrent instability; type of surgical technique for stabilization and type of fixation of the labrum. As for the treatment of recurrent instability, the same variability was seen: 36 % of the surgeons perform only arthroscopic procedures, 7 % only open and 57 % perform both open and arthroscopic procedures.ConclusionsDespite the introduction of the national guideline for the initial management of AFASD in 2005, still great variety among orthopaedic surgeons in the Netherlands was present. As for the surgical stabilization technique, the vast majority of the respondents are performing an arthroscopic shoulder stabilization procedure at the expense of the more traditional open procedure as a first treatment option for post-traumatic shoulder instability.Electronic supplementary materialThe online version of this article (doi:10.1007/s00402-015-2156-3) contains supplementary material, which is available to authorized users.

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Reduction of traumatic, primary anterior shoulder dislocations with local anesthesia

Cited by 21 publications

References 12 publications

Survey of the Management of Acute Traumatic First-Time Anterior Shoulder Dislocation Among Trauma Clinicians in the UK

Survey of the Management of Acute Traumatic First-Time Anterior Shoulder Dislocation Among Trauma Clinicians in the UK

Intra-articular lidocaine versus intravenous meperidine/diazepam in anterior shoulder dislocation: a randomised clinical trial

Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals

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