Clinical Paper: An easy method of reducing ordinary dislocations of the shoulder joint

Medical Times and Gazette, 10 March 1866, page 264

[Reproduced in Braithwaite, William: The Retrospect of Medicine, W. A. Townsend, 1866, vol. 53, page 123]

ON AN EASY METHOD OF REDUCING ORDINARY DISLOCATIONS OF THE SHOULDER JOINT.

By Wm. Elliott Porter, Esq., Linfield, Sussex.

While a student at the London Hospital a dislocated shoulder was brought in, which great force failed to reduce. On pausing for a short time before adopting other means, one of my fellow students picked up the arm and gently manipulated it; while doing so the bone slipped into its place—how none could say, but the dislocation was reduced. I thought of it a great deal, and came to the conclusion that the humerus, without the exhibition of great force, was a sufficiently powerful lever, when used as one to reduce an ordinary dislocation of the shoulder. Not long after I left the Hospital, and had to wait for some time before I had an opportunity of testing my plan.

While acting as House-Surgeon to the Dorset County Hospital in 1856, a dislocated shoulder was brought in; it was a stock case, that is, it came frequently; but it must have been troublesome to reduce, as they always used pulleys for it, and the Hospital porter began getting them in order; I thought, however, I would try my plan first.

The patient was a moderately muscular man, at about the middle period of life, and having undressed him I laid him on a mattress on the uninjured side; kneeling behind him, I placed the palm of one hand firmly on the head of the scapula and the fingers in the axilla under the head of the humerus; with the other hand I rasped the condyles and pressed the arm to the side, then drew it backwards and thus got a better hold with the fingers engaged at the head of the bone; by the next movement I slid the arm forwards and depressed the elbow, at the same time rotating outwards, and lifting the head of the bone it immediately slipped into its place.

Since I have been in practice I have tried the plan three times on healthy, muscular young men, all first dislocations; in two I succeeded quickly and easily, and failed in one which had been done three days ; the old way of the heel in the axilla was in this case after some difficulty successful.

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