FARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approach

Abstract Anterior shoulder dislocation is a common orthopedic emergency. While many reduction methods require sedation, the FARES (FAst, REliable, and Safe) and Spaso methods allow reduction without anesthesia. We conducted a single-center, prospective, randomized controlled trial comparing the FARE...

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Main Authors: Kun-Han Lee, Shu-Hao Chang, Li-Wei Hung
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-04311-x
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author Kun-Han Lee
Shu-Hao Chang
Li-Wei Hung
author_facet Kun-Han Lee
Shu-Hao Chang
Li-Wei Hung
author_sort Kun-Han Lee
collection DOAJ
description Abstract Anterior shoulder dislocation is a common orthopedic emergency. While many reduction methods require sedation, the FARES (FAst, REliable, and Safe) and Spaso methods allow reduction without anesthesia. We conducted a single-center, prospective, randomized controlled trial comparing the FARES and Spaso methods for anterior shoulder dislocation reduction. Patients aged 20 to 90 years were enrolled. The assigned closed reduction procedures were performed without patient sedation by trained orthopedic residents. If two attempts with the assigned method failed, the alternative method was used. The primary outcome was the first-attempt success rate, while secondary outcomes included overall success rate with both methods, reduction time, and pain scores. During November 2013 and December 2015, a total of 32 patients were randomized to the FARES (n = 17) or Spaso (n = 15) method. The first-attempt success rates were 71.6% for the FARES group and 80.0% for the Spaso group (p = 0.691). Among patients with failed closed reduction using the first technique, all patients in the Spaso-following-FARES group achieved successful reduction, whereas none in the FARES-following-Spaso group achieved successful reduction (p = 0.092). Pain scores during reduction were comparable between the FARES (4.29 ± 1.69) and Spaso (3.80 ± 2.65) techniques, with no statistically significant difference (p = 0.542). Follow-up data were available for 28/32 patients (87.5%; mean 5.3 ± 2.2 years). Four patients were lost (3 FARES, 1 Spaso; p = 0.726). Recurrent dislocation occurred in 3 patients (10.7%; 1 FARES, 2 Spaso; p = 0.947), and 2 patients (1 per group; p = 0.876) underwent surgery (arthroscopic stabilization and rotator cuff repair). Both the FARES and Spaso methods were effective for reducing anterior shoulder dislocations. Combining these methods may improve overall reduction rates. Clinical trial registration: This trial was registered at ClinicalTrials.gov (Registration number: NCT01979237) on 08/11/2013.
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spelling doaj-art-bbf2efe3999a475f9a522016f08af8fa2025-08-20T02:03:31ZengNature PortfolioScientific Reports2045-23222025-05-011511710.1038/s41598-025-04311-xFARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approachKun-Han Lee0Shu-Hao Chang1Li-Wei Hung2Department of Orthopedics, Shin Kong Wu Ho-Su Memorial HospitalDepartment of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic UniversityDepartment of Orthopedics, Shin Kong Wu Ho-Su Memorial HospitalAbstract Anterior shoulder dislocation is a common orthopedic emergency. While many reduction methods require sedation, the FARES (FAst, REliable, and Safe) and Spaso methods allow reduction without anesthesia. We conducted a single-center, prospective, randomized controlled trial comparing the FARES and Spaso methods for anterior shoulder dislocation reduction. Patients aged 20 to 90 years were enrolled. The assigned closed reduction procedures were performed without patient sedation by trained orthopedic residents. If two attempts with the assigned method failed, the alternative method was used. The primary outcome was the first-attempt success rate, while secondary outcomes included overall success rate with both methods, reduction time, and pain scores. During November 2013 and December 2015, a total of 32 patients were randomized to the FARES (n = 17) or Spaso (n = 15) method. The first-attempt success rates were 71.6% for the FARES group and 80.0% for the Spaso group (p = 0.691). Among patients with failed closed reduction using the first technique, all patients in the Spaso-following-FARES group achieved successful reduction, whereas none in the FARES-following-Spaso group achieved successful reduction (p = 0.092). Pain scores during reduction were comparable between the FARES (4.29 ± 1.69) and Spaso (3.80 ± 2.65) techniques, with no statistically significant difference (p = 0.542). Follow-up data were available for 28/32 patients (87.5%; mean 5.3 ± 2.2 years). Four patients were lost (3 FARES, 1 Spaso; p = 0.726). Recurrent dislocation occurred in 3 patients (10.7%; 1 FARES, 2 Spaso; p = 0.947), and 2 patients (1 per group; p = 0.876) underwent surgery (arthroscopic stabilization and rotator cuff repair). Both the FARES and Spaso methods were effective for reducing anterior shoulder dislocations. Combining these methods may improve overall reduction rates. Clinical trial registration: This trial was registered at ClinicalTrials.gov (Registration number: NCT01979237) on 08/11/2013.https://doi.org/10.1038/s41598-025-04311-xAnterior shoulder dislocationClosed reductionFARES methodSpaso methodNon-sedation reduction
spellingShingle Kun-Han Lee
Shu-Hao Chang
Li-Wei Hung
FARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approach
Scientific Reports
Anterior shoulder dislocation
Closed reduction
FARES method
Spaso method
Non-sedation reduction
title FARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approach
title_full FARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approach
title_fullStr FARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approach
title_full_unstemmed FARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approach
title_short FARES and Spaso method for anterior shoulder dislocation: a prospective randomized control study demonstrating the benefit of a combined approach
title_sort fares and spaso method for anterior shoulder dislocation a prospective randomized control study demonstrating the benefit of a combined approach
topic Anterior shoulder dislocation
Closed reduction
FARES method
Spaso method
Non-sedation reduction
url https://doi.org/10.1038/s41598-025-04311-x
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