Reduction of Anterior Glenohumeral Dislocation in Ventral Decubitus Versus Dorsal Decubitus Under Procedural Sedation (EPOLUX)

Hopital Nord Franche-Comte

Status: Completed

Conditions: Anterior Shoulder Dislocation; Emergencies; Reduction

Treatments: Procedure: reductions

Study type: Interventional

Funder types: Other

Identifiers

NCT04823689

2019-01 - EPOLUX

Details and patient eligibility

About

The anterior glenohumeral dislocation is frequently encountered in emergency medicine. It represents about 50% of the total dislocation and affects 1 resident for 10 000 in France.

In Nord Franche-Comte Hospital, 1 to 2 patients per day present this diagnosis in the emergency department, which requires reduction by external manoeuvres.

A retrospective study shows the interest of the ventral decubitus compared to dorsal decubitus reduction in the care of patients with anterior glenohumeral dislocation. None prospective study has already demonstrate the interest of the ventral decubitus compared to the dorsal decubitus in the reduction of anterior glenohumeral dislocation.

The main objective is to evaluate the speed of the reduction of the anterior dislocation of the shoulder by the ventral decubitus technique compared to the conventional technique in dorsal decubitus.

Enrollment: 120 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with radiological confirmed anterior glenohumeral dislocation
• Patient affiliated or entitled to a social security scheme
• Oral informed consent form

Exclusion criteria

• Glenohumeral fracture or vasculoneural lesion associated
• Dislocation for more than 12 hours
• Homolateral shoulder surgery antecedent
• Contraindication to other analgesics (morphine, sedation)
• BMI > 40
• Patient < 18 year
• Pregnancy or nursing woment
• Person under guardianship or curatorship

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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120 participants in 2 patient groups

Dorsal decubitus

Sham Comparator group

Description:

The dorsal decubitus reduction consists in placing the patient in the dorsal position and achieving reduction by traction maneuvers on the luxated upper limb. This maneuver generally requires procedural sedation. A mild traction of the traumatized limb in the axis is performed, with slight external rotation and progressive abduction. In the absence of reduction at this stage, this gesture is completed by a flexion adduction of the limb. A counterweight is then made by a rolled sheet and passed under the armpit of the patient.

Treatment:

Procedure: reductions

Ventral decubitus

Experimental group

Description:

The ventral decubitus reduction consists in placing the patient in the ventral position. The luxated limb is positioned in pendulum and the line of contact with the stretcher must pass through the mid-clavicular line. The humeral head is brought to the scapula.

Treatment:

Procedure: reductions