FARES Versus Traction-Countertraction for Acute Anterior Shoulder Dislocation

The FARES Versus Traction-Countertraction Technique for Acute Anterior Shoulder Dislocation: A Randomized Controlled Trial

Anterior shoulder dislocation is a common orthopedic emergency that requires prompt reduction to relieve pain and restore joint function. Several techniques have been described for closed reduction, but the optimal method remains uncertain. The FARES (Fast, Reliable, and Safe) technique is a relatively new reduction method that may provide faster reduction with less pain compared with the conventional traction-countertraction technique.

This randomized controlled trial aims to compare the effectiveness and safety of the FARES technique and the traction-countertraction technique for the reduction of acute anterior shoulder dislocation in adult patients.

Eligible participants will be randomly assigned to receive reduction using either the FARES technique or the traction-countertraction technique. The study will evaluate the success rate of reduction, pain experienced during the procedure, time required for reduction, and procedure-related complications.

The findings of this study may provide evidence to guide the selection of reduction techniques for patients with acute anterior shoulder dislocation in the emergency department.

Study Overview

• Status: Not yet recruiting
• Conditions: Acute Anterior Shoulder Dislocation
• Intervention / Treatment: Procedure: FARES Technique; Procedure: Traction-Countertraction Technique

Detailed Description

Acute anterior shoulder dislocation is one of the most common orthopedic emergencies and requires timely reduction to relieve pain, restore joint alignment, and minimize complications. Various closed reduction techniques have been described, but there is still no universal consensus regarding the optimal technique in terms of effectiveness, patient comfort, and procedural efficiency.

The FARES (Fast, Reliable, and Safe) technique is a relatively recent method for closed reduction of anterior shoulder dislocation. This technique combines gentle longitudinal traction, oscillating movements, and gradual abduction of the arm, aiming to facilitate reduction while minimizing patient discomfort. The traction-countertraction technique is a commonly used conventional method that relies on opposing forces applied by the operator and an assistant.

This study is designed to compare the outcomes of these two reduction techniques in adult patients with acute anterior shoulder dislocation. The study will evaluate whether the FARES technique provides advantages over the traction-countertraction technique regarding reduction success, pain during the procedure, reduction time, and safety outcomes.

The results of this trial may contribute to improving evidence-based decision-making for the management of acute anterior shoulder dislocation in emergency care settings.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ngoc Quyen Le, MD, PhD; Phone Number: +84903818438; Email: ngocquyenbs76@ump.edu.vn

Study Locations

• Vietnam
  • Ho Chi Minh City
    • Ho Chi Minh City, Ho Chi Minh City, Vietnam, 700000
      • Hospital for Traumatology and Orthopaedics
      • Contact: Ngoc Quyen Le, MD, PhD; Phone Number: +84903818438; Email: ngocquyenbs76@ump.edu.vn

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥18 years.
• Conscious and cooperative patients.
• Anterior shoulder dislocation confirmed by shoulder radiographs (anteroposterior view and Y-view).
• Time from injury to reduction <24 hours.
• Simple anterior shoulder dislocation or anterior shoulder dislocation associated with greater tuberosity fracture only.
• Patient agrees to participate in the study and provides informed consent.

Exclusion Criteria:

• Other injuries of the same upper extremity.
• Neurovascular deficits before reduction.
• Polytrauma, hemodynamic instability, or medical conditions contraindicating immediate reduction.
• Previous surgery of the affected shoulder.

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
Experimental: FARES Technique; Participants assigned to this arm will undergo closed reduction of acute anterior shoulder dislocation using the FARES (Fast, Reliable, and Safe) technique.	Procedure: FARES Technique; Closed reduction of acute anterior shoulder dislocation using the FARES (Fast, Reliable, and Safe) technique.
Active Comparator: Traction-Countertraction Technique; Participants assigned to this arm will undergo closed reduction of acute anterior shoulder dislocation using the conventional traction-countertraction technique.	Procedure: Traction-Countertraction Technique; Closed reduction of acute anterior shoulder dislocation using the conventional traction-countertraction technique.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Successful reduction at the first attempt	Proportion of participants achieving successful reduction using the assigned technique without requiring an alternative reduction method.	During the initial reduction procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to successful reduction	The time required to achieve successful reduction, measured from the beginning of the assigned reduction maneuver until restoration of shoulder joint alignment.	During the reduction procedure
Pain intensity during reduction procedure	Pain intensity experienced by participants during the reduction procedure, assessed using the Visual Analog Scale (VAS). The VAS is a continuous scale ranging from 0 (no pain) to 100 mm (worst imaginable pain), where higher scores indicate worse outcome.	Immediately after completion of the reduction procedure
Number of reduction attempts	The number of attempts required to achieve successful shoulder reduction using the assigned technique.	During the reduction procedure
Procedure-related complications	Incidence of complications related to the reduction procedure, including neurovascular complications and other adverse events.	During the reduction procedure and immediate post-reduction assessment
Factors associated with successful reduction	Odds ratio (with 95% confidence interval) for successful reduction associated with each baseline factor, estimated using multivariable logistic regression. Successful reduction is defined as restoration of glenohumeral joint congruity confirmed on post-reduction radiography, achieved with the allocated technique without crossover to an alternative technique or the addition of procedural sedation. Baseline factors entered into the model are age (years), sex (male/female), body mass index (kg/m²), mechanism of injury (fall / sports-related / road traffic accident / other), time from injury to reduction attempt (hours), history of recurrent shoulder dislocation (yes/no), and associated greater tuberosity fracture on pre-reduction radiography (yes/no).	From baseline assessment until completion of the reduction procedure
Pain intensity after reduction	Pain intensity after completion of the reduction procedure, assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain).	Immediately after successful reduction

Collaborators and Investigators

• Sponsor: Ngoc Quyen Le

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): April 1, 2027
• Study Completion (Estimated): April 1, 2027

Study Registration Dates

• First Submitted: July 25, 2026
• First Submitted That Met QC Criteria: August 5, 2026
• First Posted (Actual): August 11, 2026

Study Record Updates

• Last Update Posted (Actual): August 11, 2026
• Last Update Submitted That Met QC Criteria: August 5, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Keywords: Emergency department; Closed reduction; Anterior shoulder dislocation; FARES technique; Traction-countertraction technique
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Pathological Conditions, Signs and Symptoms; Emergencies
• Other Study ID Numbers: 155/2026/HĐ-ĐHYD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared with other researchers. The collected data contain clinical information obtained from participants during the study, and sharing individual-level data was not included in the approved study protocol. Only aggregated and anonymized results will be reported in scientific publications.

Drug and device information, study documents

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