Davos Technique Gains Traction for Shoulder Dislocations

Multiple methods are touted for reducing anterior shoulder dislocations, and every emergency physician seems to have gravitated to one or two methods that he uses routinely. Why someone prefers one technique over another is not clear, but the factors for technique selection seem to be training, ease of application, and prior successful experiences.Every reduction procedure will have some degree of applied rotation, torque, and traction, and pain is a common and unavoidable theme. Unfortunately, not all shoulder reductions are created equally. Variations in human anatomy, time duration of dislocation, and the actual location of the humeral head relative to the glenoid fossa will contribute to the reduction technique selection process. Consider the worst-case scenario of the intoxicated weight lifter who presents after dislocating his shoulder many hours earlier.Our attempts to overcome the serious muscle spasm holding the humeral head in its newly found location involve rotational torque, traction force, leverage maneuvers, relaxation techniques, and medications. Unfortunately, some reductions will still require a visit to the operating room and general anesthesia. And some shoulder dislocations can be successfully reduced without pain and muscle-relaxing medications, but those are less frequent and are usually performed immediately after the dislocation event.Some procedures are definitely more expedient than others and how busy the emergency department is at the time of pres...
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