Putting a Dislocated Shoulder Back in Place--The Easy WayShoulder dislocations in adults are fairly common. At the Mount Sinai Hospital in New York, the emergency room treated 42 cases in six months. Putting the head of the humerus (upper arm bone) back in the socket isn't usually hard to do. There are many ways to do it. This treatment is called shoulder reduction.
One of the most common ways to treat shoulder dislocation is to use intravenous anesthesia. This puts the patient to sleep and relaxes the muscles. The doctor can then manually release the shoulder. This method is safe, but it requires staff to monitor the patient for up to three hours after the procedure.
In the early 1990s, a group of doctors injected lidocaine into the shoulder joint. Lidocaine is a form of local numbing medicine. The patient is then placed face down on a table with a 10-pound weight attached to the hand. The weight applies a traction force to the shoulder and brings it back into the joint.
Doctors at the hospital compared the two methods of shoulder reduction. One group of patients received the injection and traction. The second group had the more traditional manual reduction with an intravenous anesthetic.
The doctors found that there was equal success reducing the shoulders with either method. The actual treatment took about the same amount of time, and the patients had the same amount of pain and discomfort. There were two ways in which the shoulder injection method was better. The first was cost. The injection costs about 50 cents, compared to almost 100 dollars for the intravenous sedation. The second was time. Patients who received the shoulder injection didn't need to be watched closely after the procedure. They could leave the hospital sooner after arriving than the sedated group. The sedation method also took the time of hospital staff. Nurses and other staff were needed to monitor the patients who had been sedated. All in all, the lidocaine method required less manpower, money, and time.
Suzanne L. Miller, MD, et al. Comparison of Intra-Articular Lidocaine and Intravenous Sedation For Reduction of Shoulder Dislocations. In The Journal of Bone and Joint Surgery. December 2002. Vol. 84-A. No. 12. Pp. 2135-2139.
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