The Elbow Technique: A Novel Reduction Technique for Anterior Shoulder Dislocations

J Emerg Med. 2019 Feb;56(2):201-204. doi: 10.1016/j.jemermed.2018.10.018. Epub 2018 Dec 6.


Background: Anterior dislocation of the glenohumeral joint is a common upper extremity injury in orthopedic and emergency medicine. The aim of this study was to introduce a novel reduction technique, "elbow technique," for anterior shoulder dislocations.

Discussion: This study included 26 patients with anterior shoulder dislocation who were treated using the elbow technique in our hospital's emergency department between October 2014 and December 2015. One orthopedic physician performed the reduction maneuver and the vast majority of the patients were sedated. Patients who presented with posterior shoulder dislocation, remained dislocated for more than 7 days, who had Neer three or four parts proximal humerus fractures, and who had received previous shoulder surgery were excluded from this study. Twenty-one dislocations (80% of the patients) were primary. Six patients (23% of the dislocations) had associated fractures of the greater tuberosity. All of the patients were successfully reduced with the elbow technique. Mean time for reduction was 5 s (range 3-69 s). No iatrogenic fractures or neurovascular injuries were noted after the reductions.

Conclusions: The elbow technique involves traction, leverage, pulsion, and can be performed by a single operator. The elbow technique is a safe, elegant, simple, effective, fast, and gentle reduction procedure for anterior shoulder dislocations in the emergency department.

Keywords: humerus; orthopaedic; shoulder dislocations; shoulder injury.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Male
  • Manipulation, Orthopedic / methods*
  • Manipulation, Orthopedic / standards
  • Middle Aged
  • Range of Motion, Articular / physiology
  • Shoulder Dislocation / therapy*
  • Shoulder Injuries
  • Shoulder Joint / abnormalities
  • Time Factors