Modified Chair Method vs. Traditional Techniques for Closed Manipulation and Relocation of Anterior Shoulder Dislocation

Background: Anterior shoulder dislocation is a frequent orthopedic emergency requiring timely and effective reduction to prevent complications. Several reduction techniques exist, with varying success rates, complication risks, and levels of patient discomfort. The Modified Chair Method (MCM) is a novel technique that may offer benefits over traditional methods. Thus, the study's objective was to compare the success rate, pain levels, complications, and need for analgesia among the Modified Chair Method, Hippocratic, Kocher, and Stimson techniques for anterior shoulder dislocation reduction. Methods: A prospective cohort study was conducted in the Emergency Department of Dr. Ziauddin Hospital, Karachi (Feb 9, 2024 – Feb 1, 2025), including 120 patients (18–65 years) with anterior shoulder dislocations via non-probability consecutive sampling. Patients were randomized into four groups (n=30) for reduction using MCM, Hippocratic, Kocher, or Stimson techniques. Outcomes assessed were success rates, VAS pain scores, reduction time, complications, and analgesia requirements. Statistical analysis (SPSS v23) used Chi-square (success, complications, analgesia) and ANOVA (pain scores), with p<0.05 considered significant. Results: MCM achieved the highest success rate (n=28, 93.3%) compared to Hippocratic (n=25, 83.3%), Kocher (n=23, 76.7%), and Stimson (n=19, 63.3%) techniques (p=0.037). MCM had the lowest mean VAS pain score (4.00 ± 2.47). Complications were least common in the MCM group. The need for analgesia was lowest with MCM (20%) and highest with Kocher (33.3%). Conclusion: The Modified Chair Method demonstrated superior efficacy, lower pain levels, and fewer complications compared to traditional methods, making it a promising first-line approach for anterior shoulder dislocation reduction in emergency settings.