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. 2015 Jul-Aug;23(4):192-6.
doi: 10.1590/1413-78522015230400701.

Glenoumeral dislocation: a prospective randomized study comparing spazo and kocher maneuvers

Bruno da Rocha Moreira Rezende  1 , José Inácio de Almeida Sr  1 , Uriel Jaime de Sousa  1 , Leônidas de Souza Bomfim  1 , Mário Soares Ferreira Jr  1
Affiliations

Glenoumeral dislocation: a prospective randomized study comparing spazo and kocher maneuvers

Bruno da Rocha Moreira Rezende et al. Acta Ortop Bras. 2015 Jul-Aug.

Abstract

Objective: To evaluate and to compare the Spaso and Kocher reduction maneuvers in terms of efficiency, time of reduction, facileness, pain, discomfort to the patient, complications and risks, besides promoting the comparison between the two maneuvers, aiming to ground the emergency conduct.

Methods: A prospective study with 105 patients with acute shoulder dislocations were enrolled in the study between February 2011 and September 2012. The patients were randomized into two groups and they were submitted to the reduction of dislocation using the Spaso maneuver (group A) or the Kocher technique (group B) by first, second or third-year orthopedic surgery residents from our service. The results were evaluated and compared.

Results: There was no statistically significant difference between the two groups in terms of age, gender, timing of reduction, number of precedent episodes and complications after reduction. However, reduction was achieved in more cases using the Spaso method than it was among the Kocher group, as well as the mean duration of the reduction maneuver and discomfort were shorter in the group A patients.

Conclusions: Both methods presented good results in terms of dislocation reduction and low complications rates. Nevertheless, the Spaso maneuver was more efficient, fast and easily applicable in comparison with Kocher's method. Level of Evidence I, Therapeutic.

Keywords: Manipulation, orthopedic/methods; Prospective studies; Shoulder dislocations; Shoulder joint.

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Conflict of interest statement

All the authors declare that there is no potential conflict of interest referring to this article.

Figures

Figure 1.
Figure 1.. Longitudinal traction.
Figure 2.
Figure 2.. External rotation.
Figure 3.
Figure 3.. Internal rotation and extension.
Figure 4.
Figure 4.. Elbow in adduction is flexed at 90°.
Figure 5.
Figure 5.. External rotation until resistance.
Figure 6.
Figure 6.. Shoulder adduction in external rotation.
Figure 7.
Figure 7.. Extension and internal rotation of the shoulder.
Figure 8.
Figure 8.. Muscular action on the shoulder in the anatomical position with three vector groups in three different directions: horizontal, vertical and oblique. Source: Milch et al.10
Figure 9.
Figure 9.. Muscular action on the elevated shoulder. Notice the alignment of the vector groups that start acting in the same direction Source: Milch et al.10
See this image and copyright information in PMC

References

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