Monday, October 5, 2009

Clarification

Ron expressed concerns about A.T.'s reducing shoulders. It all depends on your school M.D.'s standing treatment orders & your state's A.T. practice act & the need to weigh long term damage (axonotmesis etc) caused by delay in treatment. I'm not instructing here, just giving some advice based on my experience (as in all of my posts). I've heard the screams of athletes needlessly suffering from a practitioner trying to reduce a shoulder with levering/traction/thrust techniques on the field, and in the E.R. The Milch technique is the safest, gentleist of all shoulder reduction techniques. No external force by the practitioner is required. If anyone else out there is familiar with it, your comments please.

3 comments:

Kev said...

Joe,

My ortho's are comfortable in letting me try getting a GH dislocation back providing distal neurovascular exam is normal. My personal rule is that I'll try three times with a very gentle technique such as the Milch or Stinson. If no luck they go to the ER or Urgent Care.

As a side note, those kids who sublux a lot seem to be the easiest to reduce .... sometimes they even reduce themselves!

Pete Koeniges said...

I'm curious as to why you wouldn't try reduction on the field. All of my reductions were done on the field, mostly because I didn't want to risk further discomfort by moving them. Is there a danger I haven't considered?

Sarah said...

I too am curious about not reducing on the field. I've almost always reduced on the field (with Milch or distraction) without incident. Perhaps to avoid an audience for the athlete?