Introduction: Modified Steel's Maneuver for Shoulder Dislocation Reduction

Disclaimer:

This video cannot substitute proper medical attention, and it's aimed towards student doctor who need to clear their doubts. So, if you rip someone's arm off or break something, it's your neck. I cannot be held responsible for absolutely anything derived from this video, be it positive or negative. That said....

Modified Steel's Maneuver is one of the most useful weapons in an Orthopedic Surgeon's arsenal. It involves gentle, slow manipulation of the arm to an anatomical reduction. As you can see in the video, the patient is not even sedated. If performed correctly, sedation and analgesia can be avoided.

Start by calming the patient down and gently taking the arm to external rotation and abduction. As you manipulate the arm, you'll notice the scapula eaves the bed. This usually means you reached maximum external rotation, and is generally the point where the joint is reduced. Nevertheless, you must carry on with the whole procedure every time. Continue abducting the arm until the patient's hand reaches the back of their neck, and finish by adducting and internally rotating the arm to a resting position.

Immobilize the arm using a Velpeau splint for 2 to 3 weeks and start rehabilitation early, or risk a frozen shoulder syndrome

Always obtain X Rays prior and after manipulation to rule out associated fractures

Comments

author
KellyJ (author)2009-09-18

Thanks for the Video! Nice! So what are the indications that leads you to use the Modified Steel's maneuver? How did the injury present it self? I hope you do present more intractables. Thanks

author
sameotoko (author)KellyJ2009-09-21

This maneuver is used to reduce an acute anterior shoulder dislocation, but it's also useful for reducing recidivant dislocations when there's rupture of the glenohumeral ligaments, since there will be far less tension on the joint and less chance of axillar artery lesion

author
burchard (author)2009-04-13

Nicely done. A few of pounds of tension from the elbow, inline with the humerus, would help reduce patient discomfort. Thank you for posting!

author
Biotele (author)2009-03-09

Thanks, very important. Are you a chiropractor? Do you have other maneuvers?

author
sameotoko (author)Biotele2009-03-09

No, I'm an orthopedic Surgeon. Chiropractors shouldn't attepmt reduction maneuvers, since they're not properly trained physicians. There are several maneuvers for shoulder dislocation reduction, and each have their own indications. I'll try to post some more as soon as I can record them

author
Garth Knight (author)2008-06-09

Very good! Now... How do I dislocate someone's shoulder? I can't practice the reduction without "patients" to practice on... (Thinking like that, perhaps it's good I never became a doctor.) This looks really effective, good instuctable. GK

author
sameotoko (author)Garth Knight2008-06-10

you might want to look into jiu-jitsu, hapkido or sanbo for instructions on dislocating shoulders. If you've seen mission impossible 2, there's a good example at the ending, when tom cruise makes the bad guy trip with an arm bar.... just don't sweep the leg and the shoulder should come off =) Trust me, I'm a black belt in Kenpo

author
theRIAA (author)2008-06-04

that looked really cool

author
pyro222 (author)theRIAA2008-06-04

Wow, that seemed allot more pleasant than the doctors knee on my chest tugging the pillowcase wrapped around my arm treatment I received when i dislocated mine.

author
sameotoko (author)pyro2222008-06-05

It takes years to master any maneuver. As an orthopedist, this is the one that's worked wonders for me. As soon as I have some more time I'll post an instructable with diagrams explaining the anatomy behind this move. Don't forget to rate!!!

author
klee27x (author)2008-06-05

Very well done video. Thanks for sharing that.

About This Instructable

5,396views

6favorites

License:

Bio: Orthopedic surgeron, specializing in sports injuries in Mexico. Love to cook. Black belt in Karate and kenpo.
More by sameotoko:Sushi!!!Award-Winning, Cheese-Stuffed Meatballs in Chipotle SauceShark Tacos!
Add instructable to: