How is the Milch technique performed for the reduction of shoulder dislocation?

Updated: Aug 17, 2018
  • Author: Anantha K Mallia, DO, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

The patient may be supine or prone, with the shoulder close to the edge of the stretcher. The affected arm is placed in full abduction overhead, or the patient is instructed to raise the arm laterally and behind the head. The operator may assist abduction gently.

With the patient’s arm in full abduction, the physician gently applies longitudinal traction and external rotation with one arm (see the video below). If reduction is not completed, the physician uses the thumb or fingers to push the humeral head up into the glenoid fossa, with gradual adduction of the extended arm still held in traction. [7, 39]

Reduction of shoulder dislocation: Milch technique.

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