Effectiveness of the Boss-Holzach-Matter selfassisted technique for the reduction of anterior glenohumeral dislocations: systematic review

Abstract

Background: Anterior shoulder dislocation represents a common reason for emergency room visits. Despite the wide range of motion provided by this joint in three-dimensional space, it is prone to dislocation, with a significant incidence rate. The choice of reduction technique lacks consensus, with over 25 possible maneuvers, largely dependent on the physician's preference and experience. Additionally, potential neurovascular injuries resulting from the maneuver or its poor execution add complexity to this issue, challenging emergency physicians and orthopedic surgeons. The self-assisted technique Boss-Holzach-Matter (BHM) shows promising benefits in reducing patient anxiety and medical costs. Materials and Methods: A manual bibliographic search was conducted in PubMed, Scielo, and Central databases for studies from the last 10 years analyzing reduction techniques using the keywords "techniques for shoulder dislocation". Titles, abstracts, and full articles were reviewed, extracting pertinent data. Out of the 17 articles found, including systematic reviews, clinical trials, and other publications, 10 were selected without language restrictions. Results: Reduction methods varied significantly among studies. Comparison between self-assisted techniques like BHM and Spaso revealed differences in success rate and pain tolerance. The Davos technique demonstrated high effectiveness, although it was associated with potential complications. Comparative studies supported the efficacy of BHM and Milch in unassisted reduction. Conclusions: The need for further research to validate these findings, identify limitations, and evaluate clinical applicability is acknowledged. Additional studies are required to confirm the effectiveness of self-assisted techniques such as BHM, Milch, and Davos, as well as to address the potential limitations and considerations associated with each technique