{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:22Z","timestamp":1787755402945,"version":"build-2784847793"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T00:00:00Z","timestamp":1520380800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,3,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There are many different techniques for reducing acute anterior dislocations of the shoulder, and their use depends on surgeon preference. The objective of this study was to compare the pain experienced by a patient performing a self-reduction technique with the pain felt during a reduction performed by a trained physician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study was carried out at the emergency department of a tertiary referral center. Patients between 18 and 60 years of age with an acute anterior shoulder dislocation were randomly allocated into 2 groups. In 1 group the emergency doctor actively guided the reduction process with the Spaso technique (Sp group), and in the other group the patient used the Boss-Holzach-Matter (also known as Davos or Aronen) self-reduction technique (BHM group). The pain experienced by the patient during the reduction was recorded by means of a visual analogue scale (VAS) ranging from 0 to 10. Other recorded data included demographic characteristics, reduction time, and success rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 378 patients assessed for eligibility from May 2015 until February 2017, 197 did not meet the inclusion criteria, 58 met exclusion criteria, 22 declined to participate, and 41 withdrew before randomization. Sixty acute anterior shoulder dislocations were randomized into the Sp group (n = 30) or the BHM group (n = 30). The BHM group experienced significantly less pain during reduction than the Sp group (p = 0.047), with mean pain scores of 3.57 (standard deviation [SD] = 2.1]) and 5.26 (SD = 2.9), respectively. No significant difference between groups was found with respect to reduction time (105 seconds [range, 10 to 660 seconds] in the Sp group and 90 seconds [range, 5 to 600 seconds] in the BHM group; p = 0.6) or success rate (67% and 77%, respectively; p = 0.39).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The self-reduction technique results in less pain than, and is as efficient in achieving reduction of anterior shoulder dislocations as, the Spaso technique. These findings favor the use of the self-assisted method as an effective first-line treatment for shoulder dislocations seen in the emergency department as well as its use by patients with recurrent dislocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00687","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T16:48:40Z","timestamp":1520441320000},"page":"375-380","source":"Crossref","is-referenced-by-count":16,"title":["Teaching Patients How to Reduce a Shoulder Dislocation"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5690-631X","authenticated-orcid":false,"given":"F.A.","family":"Marcano-Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Orthopedic Department, Parc Taul\u00ed Hospital Universitari, Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed I3PT, Universitat Aut\u00f2noma de Barcelona, Sabadell, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Balaguer-Castro","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Parc Taul\u00ed Hospital Universitari, Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed I3PT, Universitat Aut\u00f2noma de Barcelona, Sabadell, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Fillat-Gom\u00e0","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Parc Taul\u00ed Hospital Universitari, Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed I3PT, Universitat Aut\u00f2noma de Barcelona, Sabadell, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ona","family":"R\u00e0fols-Perramon","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Parc Taul\u00ed Hospital Universitari, Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed I3PT, Universitat Aut\u00f2noma de Barcelona, Sabadell, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Torrens","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Hospital del Mar de Barcelona, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Torner","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Parc Taul\u00ed Hospital Universitari, Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed I3PT, Universitat Aut\u00f2noma de Barcelona, Sabadell, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"6","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1080\/028418500127346090","article-title":"Radiographic evaluation of anterior dislocation of the shoulder","volume":"41","author":"Ceroni","year":"2000","journal-title":"Acta Radiol."},{"issue":"3","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00264-006-0183-y","article-title":"Has the management of shoulder dislocation changed over time?","volume":"31","author":"Chalidis","year":"2007","journal-title":"Int Orthop."},{"issue":"3","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"542","DOI":"10.2106\/JBJS.I.00450","article-title":"Epidemiology of shoulder dislocations presenting to emergency departments in the United States","volume":"92","author":"Zacchilli","year":"2010","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"173","DOI":"10.2106\/00004623-194931010-00019","article-title":"The treatment of recent dislocations and fracture-dislocations of the shoulder","volume":"31","author":"Milch","year":"1949","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/j.ajem.2016.04.012","article-title":"The effectiveness of a newly developed reduction method of anterior shoulder dislocations; 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