Managing Acute Joint Dislocation With Closed-Reduction
Abstract:
Recent educational standards include formalized instruction on joint reduction techniques. Current clinicians and others who graduated before the implementation of new standards need to develop and update expertise in this area. Thus, the purpose of this session is to present a 4-step evaluation and treatment process, decision making algorithm, and multiple techniques for reducing 3 commonly dislocated joints: the glenohumeral, interphalangeal and patellofemoral joints. Joint reduction techniques covered will include the exaggeration and traction methods for the finger, patellar reduction method, and several shoulder techniques (e.g. Scapular manipulation, Stimson, FARES, Boss-Holzach-Matter maneuver, External rotation maneuver, Spaso technique, Traction-Countertraction, Hippocratic, and Eskimo). Where available research evidence supporting each technique will be reviewed (e.g. success rate, time to complete, pain), enabling the attendee to differentiate between various techniques based on patient outcomes. In addition to clinical indications and contraindications, this breakout session will address practical considerations (e.g. clinician biomechanics, utility on-the-field). These closed reduction techniques will be presented from the perspective of an athletic trainer with standing orders from a supervising physician which permit closed joint reduction under certain criteria. Recent educational standards include formalized instruction on joint reduction techniques. Current clinicians and others who graduated before the implementation of new standards need to develop and update expertise in this area. Thus, the purpose of this session is to present a 4-step evaluation and treatment process, decision making algorithm, and multiple techniques for reducing 3 commonly dislocated joints: the glenohumeral, interphalangeal and patellofemoral joints. Joint reduction techniques covered will include the exaggeration and traction methods for the finger, patellar reduction method, and several shoulder techniques (e.g. Scapular manipulation, Stimson, FARES, Boss-Holzach-Matter maneuver, External rotation maneuver, Spaso technique, Traction-Countertraction, Hippocratic, and Eskimo). Where available research evidence supporting each technique will be reviewed (e.g. success rate, time to complete, pain), enabling the attendee to differentiate between various techniques based on patient outcomes. In addition to clinical indications and contraindications, this breakout session will address practical considerations (e.g. clinician biomechanics, utility on-the-field). These closed reduction techniques will be presented from the perspective of an athletic trainer with standing orders from a supervising physician which permit closed joint reduction under certain criteria.
Learning Objectives:
- Identify the steps to a structured evaluation and treatment algorithm for closed reduction of acute dislocation.
- Identify common closed joint reduction techniques for the glenohumeral, interphalangeal and patellofemoral joint.
- Compare and contrast common closed joint reduction techniques utilizing evidence from the research literature.
- Select an appropriate closed joint reduction technique for a particular scenario.
Level:
Advanced
Domain(s):
Domain 3: Critical Incident Management
Orthopedic Domain(s):
Domain 1: Medical Knowledge
Domain 2: Procedural Knowledge
CEUs:
1.0 Category A
Keywords:
On-the-field; pre-hospital emergency care; closed reduction; dislocation
In order to earn your CEUs, you must watch the session video in its entirety and complete the assessment.
Course Expiration:
All sessions of the NATA 76th Symposia On-Demand must be completed by October 31, 2025 at 11:59 p.m. CDT.
For full details, refer to the expiration policy on our FAQ page.
Cynthia Wright, PhD, ATC
Dr. Cynthia Wright is a professor at Whitworth University. She received her BA in Athletic Training from Whitworth University, Master’s degree at Texas State University, and PhD in Rehabilitation and Movement Science at Virginia Commonwealth University. Dr. Wright teaches a variety of graduate athletic training and undergraduate health science courses and has diverse research interests. Clinically, Dr. Wright has worked as an athletic trainer in a physician practice, collegiate, and high school settings. Outside of work, you’re likely to find Dr. Wright recreating outside in the beautiful Pacific Northwest.