Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation

Background: Anterior shoulder dislocation is a frequent orthopedic emergency requiring timely and effective reduction to prevent complications. Several reduction techniques exist, with varying success rates, complication risks, and levels of patient discomfort. The Modified Chair Method (MCM) is a...

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Main Authors: Muhammad Ahmad, Naseem Munshi, Athar Munir Uddin Siddiqui, Muznha Asif, Arham Azizi, Muhammad Salman Masroor
Format: Article
Language:English
Published: ziauddin University 2025-04-01
Series:Pakistan Journal of Medicine and Dentistry
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Online Access:https://ojs.zu.edu.pk/pjmd/article/view/3571
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author Muhammad Ahmad
Naseem Munshi
Athar Munir Uddin Siddiqui
Muznha Asif
Arham Azizi
Muhammad Salman Masroor
author_facet Muhammad Ahmad
Naseem Munshi
Athar Munir Uddin Siddiqui
Muznha Asif
Arham Azizi
Muhammad Salman Masroor
author_sort Muhammad Ahmad
collection DOAJ
description Background: Anterior shoulder dislocation is a frequent orthopedic emergency requiring timely and effective reduction to prevent complications. Several reduction techniques exist, with varying success rates, complication risks, and levels of patient discomfort. The Modified Chair Method (MCM) is a novel technique that may offer benefits over traditional methods. Thus, the study's objective was to compare the success rate, pain levels, complications, and need for analgesia among the Modified Chair Method, Hippocratic, Kocher, and Stimson techniques for anterior shoulder dislocation reduction. Methods: A prospective cohort study was conducted in the Emergency Department of Dr. Ziauddin Hospital, Karachi (Feb 9, 2024 – Feb 1, 2025), including 120 patients (18–65 years) with anterior shoulder dislocations via non-probability consecutive sampling. Patients were randomized into four groups (n=30) for reduction using MCM, Hippocratic, Kocher, or Stimson techniques. Outcomes assessed were success rates, VAS pain scores, reduction time, complications, and analgesia requirements. Statistical analysis (SPSS v23) used Chi-square (success, complications, analgesia) and ANOVA (pain scores), with p<0.05 considered significant. Results: MCM achieved the highest success rate (n=28, 93.3%) compared to Hippocratic (n=25, 83.3%), Kocher (n=23, 76.7%), and Stimson (n=19, 63.3%) techniques (p=0.037). MCM had the lowest mean VAS pain score (4.00 ± 2.47). Complications were least common in the MCM group. The need for analgesia was lowest with MCM (20%) and highest with Kocher (33.3%). Conclusion: The Modified Chair Method demonstrated superior efficacy, lower pain levels, and fewer complications compared to traditional methods, making it a promising first-line approach for anterior shoulder dislocation reduction in emergency settings.
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publishDate 2025-04-01
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spelling doaj-art-5252f017e67641db8823ff4601a80c4d2025-08-20T03:08:40Zengziauddin UniversityPakistan Journal of Medicine and Dentistry2313-73712308-25932025-04-0114210.36283/ziun-pjmd14-2/037Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder DislocationMuhammad Ahmad0Naseem Munshi1Athar Munir Uddin Siddiqui2Muznha Asif3Arham Azizi4Muhammad Salman Masroor5Ziauddin Hospital ,Karachi, PakistanZiauddin Hospital ,Karachi, PakistanZiauddin Hospital ,Karachi, PakistanSohail Trust HospitalZiauddin Hospital ,Karachi, PakistanZiauddin Hospital ,Karachi, Pakistan Background: Anterior shoulder dislocation is a frequent orthopedic emergency requiring timely and effective reduction to prevent complications. Several reduction techniques exist, with varying success rates, complication risks, and levels of patient discomfort. The Modified Chair Method (MCM) is a novel technique that may offer benefits over traditional methods. Thus, the study's objective was to compare the success rate, pain levels, complications, and need for analgesia among the Modified Chair Method, Hippocratic, Kocher, and Stimson techniques for anterior shoulder dislocation reduction. Methods: A prospective cohort study was conducted in the Emergency Department of Dr. Ziauddin Hospital, Karachi (Feb 9, 2024 – Feb 1, 2025), including 120 patients (18–65 years) with anterior shoulder dislocations via non-probability consecutive sampling. Patients were randomized into four groups (n=30) for reduction using MCM, Hippocratic, Kocher, or Stimson techniques. Outcomes assessed were success rates, VAS pain scores, reduction time, complications, and analgesia requirements. Statistical analysis (SPSS v23) used Chi-square (success, complications, analgesia) and ANOVA (pain scores), with p<0.05 considered significant. Results: MCM achieved the highest success rate (n=28, 93.3%) compared to Hippocratic (n=25, 83.3%), Kocher (n=23, 76.7%), and Stimson (n=19, 63.3%) techniques (p=0.037). MCM had the lowest mean VAS pain score (4.00 ± 2.47). Complications were least common in the MCM group. The need for analgesia was lowest with MCM (20%) and highest with Kocher (33.3%). Conclusion: The Modified Chair Method demonstrated superior efficacy, lower pain levels, and fewer complications compared to traditional methods, making it a promising first-line approach for anterior shoulder dislocation reduction in emergency settings. https://ojs.zu.edu.pk/pjmd/article/view/3571Anterior shoulder dislocation, Modified Chair MethodHippocratic method
spellingShingle Muhammad Ahmad
Naseem Munshi
Athar Munir Uddin Siddiqui
Muznha Asif
Arham Azizi
Muhammad Salman Masroor
Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation
Pakistan Journal of Medicine and Dentistry
Anterior shoulder dislocation,
Modified Chair Method
Hippocratic method
title Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation
title_full Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation
title_fullStr Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation
title_full_unstemmed Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation
title_short Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation
title_sort modified chair method vs traditional techniques for closed manipulation and relocation of anterior shoulder dislocation
topic Anterior shoulder dislocation,
Modified Chair Method
Hippocratic method
url https://ojs.zu.edu.pk/pjmd/article/view/3571
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AT atharmuniruddinsiddiqui modifiedchairmethodvstraditionaltechniquesforclosedmanipulationandrelocationofanteriorshoulderdislocation
AT muznhaasif modifiedchairmethodvstraditionaltechniquesforclosedmanipulationandrelocationofanteriorshoulderdislocation
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