A Modified Chair Technique for Acute Anterior Shoulder Dislocation Compare With Traction-counter Traction Technique

A Modified Chair Technique for Acute Anterior Shoulder Dislocation Compare With Traction-counter Traction Technique : A Randomized Controlled Trial

Anterior shoulder dislocation is the most common type of joint dislocation and requires timely and effective closed reduction. The traction-counter traction technique is widely used in Thailand, although it may require patient transfer and sedation, which can increase the risk of adverse events. The modified chair technique has been introduced as a simpler, potentially more convenient method that may allow reduction to be performed in a single location

Study Overview

• Status: Completed
• Conditions: Anterior Shoulder Dislocation
• Intervention / Treatment: Procedure: Modified chair technique; Procedure: Traction-counter traction technique

• Study Type: Interventional
• Enrollment (Actual): 68
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Thailand
  • Changwat Khon Kaen
    • Khon Kaen, Changwat Khon Kaen, Thailand, 40000
      • Khon Kaen hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Patients diagnosed with anterior shoulder dislocation based on physical examination and radiographic findings, including both first-episode (primary) and recurrent cases.
• Patients aged 18 years or older.
• Patients who are fully conscious and able to provide informed consent.
• Patients with a Glasgow Coma Score (GCS) of 15.

Exclusion Criteria:

• Patients with a history of seizure prior to the current injury.
• Patients with vascular or neurological deficits detected on physical examination.
• Patients with associated humeral fractures identified on radiographic imaging.
• Patients with multiple traumatic injuries involving.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Modified chair technique	Procedure: Modified chair technique; Modified Chair Technique is a closed reduction method for acute anterior shoulder dislocation that adapts the traditional chair technique to improve convenience and safety in the emergency setting. Instead of using a standard chair backrest, this modified approach utilizes the side rail of a patient transport stretcher, which serves as a stable fulcrum beneath the patient's axilla.
Active Comparator: traction-counter traction teahnique	Procedure: Traction-counter traction technique; Traction-Counter Traction Technique is applying longitudinal traction to the affected arm while simultaneously providing counter traction across the patient's torso, allowing controlled separation of the humeral head from surrounding soft tissues to facilitate reduction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
To compare the success rate of shoulder reduction between the modified chair technique and the traction-counter traction technique in patients with acute anterior shoulder dislocation.	immediate after procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To compare the level of pain during the shoulder reduction procedure between the modified chair technique and the traction-counter traction technique.	we record pain with visual analog scale range from 0 to 10	immediate after procedure
Evaluate the complications associated with shoulder reduction from using the modified chair technique and the traction-counter traction technique.	Complication such as brachial plexus injury, proximal humerus fracture, muscle spasm	30 minute after procedure

Collaborators and Investigators

• Sponsor: Khon Kaen Hospital

Publications and helpful links

General Publications

• Dreu M, Aufmesser W, Aufmesser H, Dolcet C, Feigl G, Sadoghi P. A simple and gentle technique for reduction after anterior shoulder dislocation. Arch Orthop Trauma Surg. 2015 Oct;135(10):1379-84. doi: 10.1007/s00402-015-2279-6. Epub 2015 Jul 21.
• Smith SL. An investigation comparing the Oxford Chair Technique with the traditional methods of glenohumeral dislocation reduction currently implemented. Int Emerg Nurs. 2009 Jan;17(1):38-46. doi: 10.1016/j.ienj.2008.09.004. Epub 2008 Nov 25.
• Sayegh FE, Kenanidis EI, Papavasiliou KA, Potoupnis ME, Kirkos JM, Kapetanos GA. Reduction of acute anterior dislocations: a prospective randomized study comparing a new technique with the Hippocratic and Kocher methods. J Bone Joint Surg Am. 2009 Dec;91(12):2775-82. doi: 10.2106/JBJS.H.01434.
• Mahirogullari M, Akyildiz F, Koksal I, Cakmak S, Kurklu M, Kuskucu M. Chair method: a simple and effective method for reduction of anterior shoulder dislocation. Acta Orthop Traumatol Turc. 2012;46(2):102-6. doi: 10.3944/AOTT.2012.2676.
• Ghane MR, Hoseini SH, Javadzadeh HR, Mahmoudi S, Saburi A. Comparison between traction-countertraction and modified scapular manipulation for reduction of shoulder dislocation. Chin J Traumatol. 2014 Apr 1;17(2):93-8.
• Guler O, Ekinci S, Akyildiz F, Tirmik U, Cakmak S, Ugras A, Piskin A, Mahirogullari M. Comparison of four different reduction methods for anterior dislocation of the shoulder. J Orthop Surg Res. 2015 May 28;10:80. doi: 10.1186/s13018-015-0226-4.
• Fennelly JT, Gourbault L, Neal-Smith G, Pradhan A, Gade V, Baxter JA. A systematic review of pre-hospital shoulder reduction techniques for anterior shoulder dislocation and the effect on patient return to function. Chin J Traumatol. 2020 Oct;23(5):295-301. doi: 10.1016/j.cjtee.2020.08.003. Epub 2020 Aug 12.
• Cunningham NJ. Techniques for reduction of anteroinferior shoulder dislocation. Emerg Med Australas. 2005 Oct-Dec;17(5-6):463-71. doi: 10.1111/j.1742-6723.2005.00778.x.
• Alkaduhimi H, van der Linde JA, Willigenburg NW, van Deurzen DFP, van den Bekerom MPJ. A systematic comparison of the closed shoulder reduction techniques. Arch Orthop Trauma Surg. 2017 May;137(5):589-599. doi: 10.1007/s00402-017-2648-4. Epub 2017 Mar 1.

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2023
• Primary Completion (Actual): October 31, 2025
• Study Completion (Actual): October 31, 2025

Study Registration Dates

• First Submitted: December 10, 2025
• First Submitted That Met QC Criteria: December 23, 2025
• First Posted (Actual): December 24, 2025

Study Record Updates

• Last Update Posted (Actual): December 24, 2025
• Last Update Submitted That Met QC Criteria: December 23, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: KEF66038

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No