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Scientific Articles   |    
Reduction of Acute Anterior Dislocation with the FARES Method
Fares E. Sayegh, MD1; Eustathios I. Kenanidis, MD2; Kyriakos A. Papavasiliou, MD3; Michael E. Potoupnis, MD4; Stavros Pellios, MD1; John M. Kirkos, MD5; George A. Kapetanos, MD6
1 “Papageorgiou” General Hospital, Ring-Road, North Efkarpia, 546 03 Thessaloniki, Greece
2 7 Anoikseos Street, 570 10 Thessaloniki, Greece. E-mail address: stathiskenanidis@gmail.com
3 3 Natalias Mela Street, 546 46 Thessaloniki, Greece
4 65 Olinthou Street, 543 51 Thessaloniki, Greece
5 138 Al. Papanastasiou Street, 542 49 Thessaloniki, Greece
6 8 25th Martiou Street, 552 36 Panorama, Thessaloniki, Greece
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Based on an original article: J Bone Joint Surg Am. 2009 Dec;91(12):2775-82.



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2012 Jul 11;2(3):1-7. doi: 10.2106/JBJS.ST.K.00043
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Extract

Overview
Introduction

The FARES (Fast, Reliable, and Safe) method is a new way to reduce acute anterior glenohumeral dislocations that combines the application of gentle longitudinal traction, vertical oscillation movements, and abduction and external rotation of the arm.

Step 1: Position the Patient

Place the patient supine on a stretcher, with his/her elbow extended, and advise him/her to hold the stretcher with the opposite hand.

Step 2: Brief the Patient

Convince the patient that his/her cooperation is necessary for a better outcome.

Step 3: Hold the Arm

Holding the patient’s hand with both of your hands, with his/her elbow extended and forearm in neutral rotation, start the procedure at 30° of shoulder abduction.

Step 4: Apply Traction and Add Oscillations

Applying gentle longitudinal traction to keep the arm extended, add gentle vertical oscillating movements.

Step 5: Abduct and Externally Rotate the Arm

Gradually abduct the arm to 90° and then gradually externally rotate the arm to achieve full external rotation.

Step 6: Achieve Reduction

The dislocation is usually reduced once 120° to 150° of shoulder abduction has been achieved.

Results

In our previously published prospective randomized study, the FARES method was compared with the Hippocratic and the Kocher methods12.

What to Watch For

Indications

Contraindications

Pitfalls & Challenges

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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