Evidence map›Paper›PMID 36856781›Full record

SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023

Effects of reduction technique for acute anterior shoulder dislocation without sedation or intra-articular pain management: a systematic review and meta-analysis.

D N Baden, M F L Visser, M H Roetman, D P J Smeeing, R M Houwert, R H H Groenwold, O A J van der Meijden

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

D N BadenEmergency Physician, Diakonessenhuis, Utrecht, The Netherlands. dnbaden@gmail.com.ORCID http://orcid.org/0000-0003-0119-6001
M F L VisserMedical Student, Amsterdam UMC, Amsterdam, The Netherlands.
M H RoetmanNurse Practitioner, Flevoziekenhuis, Almere, The Netherlands.
D P J SmeeingTrauma Surgeon in Training, UMC Utrecht, Utrecht, The Netherlands.
R M HouwertTrauma Surgeon, UMC Utrecht, Utrecht, The Netherlands.
R H H GroenwoldDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
O A J van der MeijdenOrthopedic Surgeon, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands.
University Medical Center Utrecht · NLAlbert Schweitzer Ziekenhuis · NLAmsterdam University Medical Centers · NLDiakonessenhuis hospital · NLFlevoziekenhuis · NLLeiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAnterior shoulder dislocations are commonly seen in the emergency department for which several closed reduction techniques exist. The aim of this systematic review is to identify the most successful principle of closed reduction techniques for an acute anterior shoulder dislocation in the emergency department without the use of sedation or intra-articular lidocaine injection.

methodsA literature search was conducted up to 15-08-2022 in the electronic databases of PubMed, Embase and CENTRAL for randomized and observational studies comparing two or more closed reduction techniques for anterior shoulder dislocations. Included techniques were grouped based on their main operating mechanism resulting in a traction-countertraction (TCT), leverage and biomechanical reduction technique (BRT) group. The primary outcome was success rate and secondary outcomes were reduction time and endured pain scores. Meta-analyses were conducted between reduction groups and for the primary outcome a network meta-analysis was performed.

resultsA total of 3118 articles were screened on title and abstract, of which 9 were included, with a total of 987 patients. Success rates were 0.80 (95% CI 0.74; 0.85), 0.81 (95% CI 0.63; 0.92) and 0.80 (95% CI 0.56; 0.93) for BRT, leverage and TCT, respectively. No differences in success rates were observed between the three separate reduction groups. In the network meta-analysis, similar yet more precise effect estimates were found. However, in a post hoc analysis the BRT group was more successful than the combined leverage and TCT group with a relative risk of 1.33 (95% CI 1.19, 1.48).

conclusionAll included techniques showed good results with regard to success of reduction. The BRT might be the preferred technique for the reduction of an anterior shoulder dislocation, as patients experience the least pain and it results in the fastest reduction.

Indexed as

Shoulder DislocationHumansInjections, Intra-ArticularLidocainePainLidocaineBiomechanical reduction techniquesLeverage techniqueReduction successShoulder dislocationSystematic reviewTraction–countertraction technique

Identifiers

PMID36856781
PMCPMC10229450
OpenAlexW4322720222

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.