The modified manes: a novel shoulder reduction maneuver

There is a myriad of shoulder reduction techniques documented in literature with no singular technique demonstrating superiority over the others. In this technique guide, we demonstrate a modification to the existing Manes technique. The surgeon’s forearm is placed on the patient’s posterior proximal humerus and the other hand is placed on the patient’s forearm, providing gentle traction. The forearm on the proximal humerus then applies anterior directed force first to clear the glenoid rim, followed by a laterally directed force and internal rotation to reduce the humeral head into the glenoid socket. Crucially, an assistant should be on the patient’s contralateral side applying downward pressure on the patient’s sternum. This ensures that the patient’s glenoid does not travel translate anteriorly in conjunction with the humeral head. Once a palpable clunk indicating reduction occurs, the arm is placed into a sling or immobilizer to prevent any additional dislocation events immediately after. This technique allows for consistent and reliable reduction of anterior shoulder dislocation while minimizing iatrogenic damage to the humeral head and glenoid rim.