Efficacy of Supervised Self-Reduction vs Physician-Assisted Techniques for Anterior Shoulder Dislocations: A Systematic Review and Meta-Analysis

Abstract background: The purpose of this study is to compare the efficacy of supervised self-reduction procedures versus physician-assisted techniques for treating anterior shoulder dislocations. Method: We conducted a comprehensive search on PubMed, Scopus, Web of Science, and Cochrane up to March 22, 2023, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Relevant articles were reviewed, with a focus on studies comparing supervised self-reduction techniques to physician-assisted techniques in cases of anterior shoulder dislocation. Results: The meta-analysis included four studies, with 283 patients in the physician-assisted group and 180 patients in the supervised self-reduction group participating. The success rate of supervised self-reduction techniques was significantly higher, with an odds ratio of 2.71 (95% CI 1.25-5.58, p-value = 0.01). Based on the Visual Analog Scale (VAS) score, the physician-assisted group reported significantly higher maximum pain, with a mean difference of 1.98 (95% CI 1.24-2.72, p-value < 0.01). Conclusion: Supervised self-assisted techniques outperform in terms of success rate and reduction-related maximum pain. These techniques could be used as an effective first-line treatment for anterior shoulder dislocation, potentially reducing the need for analgesics and emergency room visits.