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conferenceseries.com
March 13-14, 2017 London, UK
3rd Annual Congress and Medicare Expo on
Trauma & Critical Care
Volume 6, Issue 1 (Suppl) J Trauma Treat 2017
ISSN: 2167-1222, JTM an open access journal Trauma 2017
March 13-14, 2017
J Trauma Treat 2017, 6:1 (Suppl)
Scapulohumeral maneuver for shoulder dislocation
Sanjay V Sonanis, S Kumar, N Deshmukh, A Chikate, C Wray and D Beard
Bronglais Hospital- Hywel Dda University Health Board, UK
Aprospective study was done to analyze the results of scapulohumeral maneuver (SHM) to reduce the shoulder dislocations. An
assistant stabilizes the affected limb by holding at the forearm and maintaining the elbow in 90° flexion with mild traction. The
surgeon’s left hand is placed in the patient’s left axilla holding the proximal humerus between his fingers and the thumb. The right
palm is kept over the superior surface of the acromion. With assistant stabilizing the limb, a lateral thrust is applied by the left hand
of the surgeon at the proximal humerus and at the same time surgeon’s right palm pushing the acromion downwards to rotate the
scapula so as to face the glenoid towards the humeral head. The shoulder relocates with a click. Check radiographs were done and
the patients were immobilized in collar and cuff for three weeks and then mobilized with physiotherapy and were followed up for 12
weeks. 27 patients with shoulder dislocations were treated by scapulohumeral maneuver in Airedale NHS trust (20) and other NHS
hospitals (7). 12 males and 15 females were treated in casualty under sedation and one under GA in operation theatre. 26 patients had
anterior dislocations and one patient had an inferior dislocation. Three patients had history of previous dislocations. One pregnant
lady (38 weeks) with recurrent dislocation had to be reduced under local anesthesia. Four patients had previous other methods failed
for reduction. SHM was attempted primarily in 23 patients. There were no complications, but the method failed in one muscular
patient in which the shoulder reduced spontaneously under sedation. Average time required for the maneuver was 30 to 45 seconds.
We conclude that the SHM was technically easy, traumatic and reliable in the cases we have studied.
Does dose matter? Rehabilitation intensity and early functional recovery in older adults following mild
and moderate traumatic brain injury
Linda L Herrmann
New York University, USA
This study describes the impact of modifiable variables (discharge destination and intensity of rehabilitation) on early functional
recovery of adults 65 and older following mild and moderate traumatic brain injury (TBI). Previous studies demonstrate that
greater intensity of inpatient rehabilitation in TBI patients contribute to improved rates of functional recovery; however, studies are
limited by exclusion of/limited number of adults over age 65, and inclusion of patients who only received rehabilitation in the inpatient
setting. Functional recovery was measured by clinician rated functional independence measure (FIMTM) and by participant self-
report using the river mead head injury follow up questionnaire (RHFUQ). The sample consisted of 70 community dwelling adults
aged 65 and older hospitalized for a mild or moderate TBI. A descriptive longitudinal cohort design was used to explore discharge
destination and trajectory of early functional recovery; intensity of rehabilitative services and their relative contribution to early
functional recovery at two and six weeks post discharge. Correlations, regression, and repeated measures analysis of covariance
(ANCOVA) were used. Major findings from this study indicate that intensity of rehabilitation significantly and positively affected
the trajectory of recovery of motor function over time; greater improvement in motor and cognitive function was noted in the
high intensity group; and, patterns of self-reported difficulties varied by intensity of rehabilitation. Severity of TBI and presence of
co-morbidities were significant predictors of discharge destination to home or skilled nursing facility. The trajectory of recovery of
motor function and self-reported difficulties in older adults following mild and moderate TBI is significantly affected by intensity
of rehabilitation. Additional research is necessary to examine rehabilitation intensity as it occurs in all settings and its longitudinal
effect on the trajectory of motor, cognitive and psychosocial recovery and are essential if losses are to be integrated meaningfully into
a person’s daily life.