An easy method to reduce anterior shoulder dislocation: the Spaso technique

Authors: M-C Yuen, P-G Yap, Y-T Chan, W-K Tung

References: Emerg Med J 2001; 18:370-372

Objective—To introduce the Spaso technique for reducing anterior shoulder dislocation by reporting the success rate of the Spaso technique performed by junior emergency medicine residents.

Design—Retrospective case series.

Setting—Urban accident and emergency department.

Participants—Patients with anterior shoulder dislocations.

Interventions—The Spaso technique was applied by the emergency medicine residents to reduce anterior shoulder dislocation.

Results—The emergency medicine residents applied the Spaso technique to reduce 16 cases of anterior dislocated shoulder during the study period. The Spaso technique was successful in 14 of 16 cases. The overall success rate was 87.5% (95% CI 60.4, 97.8%). No complications were noted.

Conclusion—A new method has been introduced for reduction of anterior shoulder dislocation by reporting the experience of junior residents. The Spaso technique is simple, effective and able to be performed by single operator. Although the sample size was small, the result of the study could provide background information for planning a properly designed randomised controlled trial to evaluate the Spaso technique.

Keywords: shoulder dislocation; Spaso technique

Spaso technique:

1) Place the patient in the supine position, and grasp the affected arm around the wrist and gently lift it vertically;
2) When the affected arm is in the vertical position, apply traction to the affected arm;
3) While maintaining vertical traction, the rotate the shoulder externally;
4) If difficulty is experienced, it may be helpful to palpate the head of humerus and gently push it to assist reduction, whilst maintaining traction with the other hand.

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