Literature DB >> 28852334

Should All Shoulder Dislocations be Closed Reduced? Assessment of Risk of Iatrogenic Injury in 150 Patients.

Olga Solovyova1, Rachel Shakked1, Nirmal C Tejwani1.   

Abstract

AIMS: The purpose of this study was to determine if there was an association between iatrogenic fractures and closed reduction of shoulder dislocations. PATIENTS AND METHODS: In a retrospective case series, 150 consecutive patients with acute first time shoulder dislocations were evaluated. Patient demographics, direction of dislocation, associated injuries, reduction methods, number of attempts, and type of anesthesia/analgesia were determined. Pre- and post-reduction radiographs and medical record were reviewed to identify the presence of proximal humerus fractures.
RESULTS: There were thirty nine fracture-dislocations (26%) of the proximal humerus. Eight patients (5%) failed reduction on initial attempt. Four of these (3%) were unable to be reduced in the emergency room and were taken to OR for reduction. There was no statistically significant difference in reduction maneuver or type of anesthesia/analgesia used when comparing fracture-dislocations to dislocations only (p<0.05). No new fractures after reduction were identified.
CONCLUSION: Iatrogenic fractures of the proximal humerus due to reduction of a shoulder dislocation are extremely rare. None were identified in this review of 150 patients. We believe that closed reduction is safe even in the setting of fracture dislocations.

Entities:  

Mesh:

Year:  2017        PMID: 28852334      PMCID: PMC5508270     

Source DB:  PubMed          Journal:  Iowa Orthop J        ISSN: 1541-5457


  22 in total

1.  Iatrogenic propagation of anterior fracture-dislocations of the proximal humerus: case series and literature review with suggested guidelines for treatment and prevention.

Authors:  Anil S Ranawat; Gregory S DiFelice; Michael Suk; Dean G Lorich; David L Helfet
Journal:  Am J Orthop (Belle Mead NJ)       Date:  2007-09

2.  Management of first-time dislocations of the shoulder in patients older than 40 years: the prevalence of iatrogenic fracture.

Authors:  Ehud Atoun; Ali Narvani; Tirtza Even; Hitesh Dabasia; Alexander Van Tongel; Giuseppe Sforza; Ofer Levy
Journal:  J Orthop Trauma       Date:  2013-04       Impact factor: 2.512

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Journal:  Arch Orthop Trauma Surg       Date:  1989       Impact factor: 3.067

4.  Epidemiology of shoulder dislocations presenting to emergency departments in the United States.

Authors:  Michael A Zacchilli; Brett D Owens
Journal:  J Bone Joint Surg Am       Date:  2010-03       Impact factor: 5.284

5.  Anterior fracture-dislocations of the shoulder: pitfalls in treatment.

Authors:  R D Ferkel; A K Hedley; J J Eckardt
Journal:  J Trauma       Date:  1984-04

6.  Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee.

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Journal:  J Orthop Trauma       Date:  2007 Nov-Dec       Impact factor: 2.512

7.  Incidence and causes of shoulder girdle injuries in an urban population.

Authors:  A Nordqvist; C J Petersson
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8.  The incidence and characteristics of shoulder instability at the United States Military Academy.

Authors:  Brett D Owens; Michele L Duffey; Bradley J Nelson; Thomas M DeBerardino; Dean C Taylor; Sally B Mountcastle
Journal:  Am J Sports Med       Date:  2007-07       Impact factor: 6.202

9.  The role of post-reduction radiographs after shoulder dislocation.

Authors:  Joseph H Kahn; Supriya D Mehta
Journal:  J Emerg Med       Date:  2007-06-13       Impact factor: 1.484

10.  Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada.

Authors:  Timothy Leroux; David Wasserstein; Christian Veillette; Amir Khoshbin; Patrick Henry; Jaskarndip Chahal; Peter Austin; Nizar Mahomed; Darrell Ogilvie-Harris
Journal:  Am J Sports Med       Date:  2013-11-25       Impact factor: 6.202

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  4 in total

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Authors:  Ofir Chechik; Eran Maman; Efi Kazum; Alon Grunstein; Dvir Ben-Shabat; Ran Lin; Ben Efrima; Shai Factor; Dani Rotman; Rafael Krespi; Oleg Dolkart; Ron Rosenthal
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2020-10-08       Impact factor: 4.342

2.  Should closed reduction be attempted in the emergency department for an acute anterior shoulder fracture dislocation?

Authors:  Wei Yuan; Ivan Tjun Huat Chua
Journal:  JSES Int       Date:  2020-11-27

3.  Success rate of anterior shoulder dislocation reduction by emergency physicians: a retrospective cohort study.

Authors:  Minoru Hayashi; Shinsuke Tanizaki; Naru Nishida; Ryo Shigemi; Chihiro Nishiyama; Jyunya Tanaka; Kenichi Kano; Hiroyuki Azuma; Makoto Sera; Hideya Nagai; Shigenobu Maeda; Hiroshi Ishida
Journal:  Acute Med Surg       Date:  2022-04-19

4.  Iatrogenic fracture during shoulder dislocation reduction: characteristics, management and outcomes.

Authors:  Xiaohui Pan; Yong Yao; Hongyong Yan; Jun Wang; Lei Dai; Xincong Qu; Zuyi Fang; Feng Feng; Yan Zhou
Journal:  Eur J Med Res       Date:  2021-07-12       Impact factor: 2.175

  4 in total

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