Document Detail


The effectiveness of a specially designed shoulder chair for closed reduction of acute shoulder dislocation in the emergency department: a randomised control trial.
MedLine Citation:
PMID:  23100318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: The objective of this study was to demonstrate the effectiveness of a specially designed chair for closed reduction of acute shoulder dislocations.
METHOD: This was a prospective, non-blinded randomised controlled trial conducted in a university affiliated emergency department (ED). The inclusion criteria were (1) age ≥18 years; (2) anterior or posterior shoulder dislocation without fracture of the surgical neck of the humerus; (3) patient who is able to communicate and cooperate. Participants were randomly assigned using a computer generated random number sequence into one of two groups--either the traditional practice group or Oxford chair group. Administration of intravenous sedation was only permitted in the traditional practice group due to the concerns of sedation use in the sitting position while unsupported on the chair. The primary outcome measure was length of ED stay. The secondary outcome measures were length of time for the procedure, successful reduction rate, levels of pain experienced by patients in different time periods before and after the reduction.
RESULT: Sixty eligible patients were recruited, 30 in each group. The median lengths of stay in the ED in Oxford chair group (n=30) and traditional method group (n=30) were 152 min and 173 min respectively (p=0.183). The median procedure time was 3 min for the Oxford chair group compared to 5 min in the traditional method group (p=0.179). The success rate for the Oxford chair method was 77% (23/30). There were no statistically or clinically significant differences of pain score at any point.
CONCLUSIONS: The chair method had a 77% success rate in reducing acute shoulder dislocations without sedation. There was no difference in pain level experienced by patients between the chair method and the traditional method. Patient factors, including patients who have had previous shoulder surgery and patients who have fracture dislocations, contribute to the reduced efficacy of the chair method. It remains possible that the chair method may reduce patient length of stay in the ED in uncomplicated patients.
Authors:
Josephine Yuen Man Chung; Chi Hung Cheng; Colin A Graham; Timothy H Rainer
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-10-25
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  30     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-09     Completed Date:  2014-03-26     Revised Date:  2014-03-31    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  795-800     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Durable Medical Equipment
Emergency Service, Hospital*
Emergency Treatment / instrumentation*,  methods
Equipment Design
Female
Humans
Length of Stay / statistics & numerical data
Male
Manipulation, Orthopedic / instrumentation*,  methods
Middle Aged
Pain Measurement / statistics & numerical data
Patient Positioning / instrumentation*,  methods
Prospective Studies
Shoulder Dislocation / therapy*
Young Adult
Comments/Corrections
Comment In:
Emerg Med J. 2014 Mar;31(3):255   [PMID:  24351521 ]
Emerg Med J. 2014 Mar;31(3):255-6   [PMID:  24428982 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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