Anterior Shoulder DislocationNCT07652671
Modified Cunningham Technique for Anterior Shoulder Dislocation
A study testing Standard Cunningham Technique and Modified Cunningham Technique in people with Anterior Shoulder Dislocation and Closed Reduction, run by Antalya Health Sciences University at 1 site in Turkey (Türkiye).
Trial summary
Anterior shoulder dislocation is a common emergency condition that usually requires closed reduction in the emergency department. Several reduction techniques are used in clinical practice, and the ideal method should be effective, fast, easy to perform, well tolerated by the patient, and associated with a low need… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Anterior Shoulder Dislocation, Closed Reduction, Modified Cunningham Technique
- What is being tested?
- Standard Cunningham Technique and Modified Cunningham Technique
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 64 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Dec 2024to 5 Jun 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18 years or older
- Presentation to the emergency department with acute anterior shoulder dislocation
- Diagnosis of anterior shoulder dislocation confirmed by clinical examination and radiographic imaging
- Conscious and cooperative patients who are able to comply with the seated reduction procedure
- No associated mechanical pathology such as fracture, open wound, laceration, foreign body, or other traumatic condition preventing closed reduction
- Ability to provide written informed consent for participation in the study
Who cannot join
- Refusal to participate in the study
- Missing or unavailable study data
- Posterior or inferior shoulder dislocation
- Fracture-dislocation or associated fracture
- Open shoulder injury or significant laceration
- Foreign body or other mechanical pathology involving the affected shoulder
Show all 12Show fewer
- Neurovascular deficit requiring urgent surgical or orthopedic evaluation
- Multiple trauma
- Altered mental status or inability to cooperate during the procedure
- Previous surgery on the affected shoulder
- Unsuitability for reduction in the seated position
- Requirement for immediate procedural sedation before the first reduction attempt
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
University of Health Sciences, Antalya Training and Research Hospital
Antalya, konyaaltı, 07100
About this study
Official title: Comparison of the Standard Cunningham Technique and the Modified Cunningham Technique in Terms of Reduction Success and Emergency Department Discharge Time in Patients With Anterior Shoulder Dislocation: A Two-Center Prospective Randomized Study
Anterior shoulder dislocation is a common emergency condition that usually requires closed reduction in the emergency department. Several reduction techniques are used in clinical practice, and the ideal method should be effective, fast, easy to perform, well tolerated by the patient, and associated with a low need for sedation.
This two-center prospective randomized study compares the standard Cunningham technique with a modified Cunningham technique in adult patients presenting to the emergency department with anterior shoulder dislocation. Eligible patients were randomly assigned to one of two groups: standard Cunningham technique or modified Cunningham technique.
Read more
The main aim of the study is to compare the success rate of shoulder reduction between the two techniques. Secondary aims include comparing reduction time, pain level measured by the Visual Analog Scale, need for additional reduction maneuvers, need for sedation, emergency department discharge time, and procedure-related complications.
The study is designed to determine whether the modified Cunningham technique can provide faster and more successful shoulder reduction without increasing patient discomfort or complication risk.
Read the detailed description
Anterior shoulder dislocation is one of the most common joint dislocations encountered in emergency departments. Closed reduction is the standard initial treatment in suitable patients. Although several reduction techniques are available, many methods require traction, patient tolerance, analgesia, or procedural sedation. These factors may prolong the reduction process, increase emergency department workload, and expose patients to sedation-related risks.
The Cunningham technique is a seated, patient-cooperation-based shoulder reduction method that aims to facilitate reduction by relaxation of the shoulder girdle muscles and massage of the biceps, deltoid, and trapezius muscles. The modified Cunningham technique used in this study preserves the basic principles of the standard technique but adds a controlled positioning maneuver. In the modified technique, the patient's affected hand is placed on the volar aspect of the physician's elbow, while the physician supports the patient's elbow and applies gentle downward pressure to the antecubital region together with muscle massage. This modification is intended to provide better control of the extremity, facilitate muscle relaxation, and support reduction without forceful traction.
This was a two-center, prospective, randomized, open-label, parallel-group study conducted in emergency department settings. Adult patients presenting with acute anterior shoulder dislocation were evaluated for eligibility. Patients meeting the inclusion criteria were randomly assigned to undergo closed reduction using either the standard Cunningham technique or the modified Cunningham technique.
The reduction procedure was performed by emergency physicians according to the assigned technique. Reduction success was assessed clinically and confirmed by post-reduction radiographic imaging when clinically appropriate. In patients in whom the assigned initial technique was unsuccessful, further management, including additional reduction maneuvers, procedural sedation, or orthopedic consultation, was performed according to routine clinical practice.
The study was designed to evaluate whether the modified Cunningham technique improves the clinical efficiency of anterior shoulder dislocation reduction in the emergency department without increasing pain or procedure-related complications. No investigational drug, biological product, or medical device was used in this study.
- Being tested
- Standard Cunningham Technique, Modified Cunningham Technique
- Keywords
- Anterior Shoulder Dislocation, Closed reduction, Modified Cunningham technique, Emergency department, Shoulder dislocation
- Medical subject headings
- Emergencies, Shoulder Dislocation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Standard Cunningham TechniqueProcedure or surgery
Closed reduction of anterior shoulder dislocation using the standard Cunningham technique. The participant is seated, the affected upper extremity is supported in adduction and elbow flexion, and the physician applies massage to the biceps, deltoid, and trapezius muscles to facilitate muscle relaxation and shoulder reduction without forceful traction.
Modified Cunningham TechniqueProcedure or surgery
Closed reduction of anterior shoulder dislocation using the modified Cunningham technique. The participant is seated, and the affected hand is placed on the volar aspect of the physician's elbow. The physician supports the participant's elbow and applies gentle downward pressure to the antecubital region while performing massage of the biceps, deltoid, and trapezius muscles to facilitate reduction without forceful traction.
| Study group | Role | What they receive |
|---|---|---|
| Standard Cunningham Technique | Active comparator | Participants in this arm underwent closed reduction of anterior shoulder dislocation using the standard Cunningham technique. The patient was placed in a seated position, and reduction was attempted through patient relaxation and massage of the biceps, deltoid, and trapezius muscles without forceful traction. Receives: Procedure: Standard Cunningham Technique |
| Modified Cunningham Technique | Experimental | articipants in this arm underwent closed reduction of anterior shoulder dislocation using the modified Cunningham technique. The patient was placed in a seated position, and the affected hand was positioned on the volar aspect of the physician's elbow. The physician supported the patient's elbow and applied gentle downward pressure to the antecubital region while performing massage of the biceps, deltoid, and trapezius muscles to facilitate reduction without forceful traction. Receives: Procedure: Modified Cunningham Technique |
What is being measured
The primary outcome is the main question the study is designed to answer.
Successful Shoulder Reduction Rate
Success rate of anterior shoulder dislocation with modified Cunningham reduction technique
Measured: 1 hour
Secondary outcomes (6)
Reduction Time
The time elapsed from the initiation of the modified Cunningham reduction maneuver to clinical confirmation of shoulder reduction.
Measured: 1 hour
Procedure-Related Pain Score
Pain intensity associated with the reduction procedure was assessed using the Visual Analog Scale. Higher scores indicate greater pain intensity. (0: no pain. 10: most severe pain)
Measured: 1 hour
Need for Additional Reduction Maneuver
The proportion of participants who required an additional reduction maneuver after failure of the initially assigned technique.
Measured: 1 hour
Need for Procedural Sedation
The proportion of participants who required procedural sedation due to unsuccessful reduction or inadequate tolerance of the initially assigned reduction technique.
Measured: 1 hour
Emergency Department Discharge Time
The time from emergency department admission to discharge from the emergency department, measured in minutes.
Measured: Procedure-Related Complications
Procedure-Related Complications
Complications related to the procedure include: neurovascular injury, fracture, recurrent dislocation, need for orthopedic consultation, or the need for further intervention.
Measured: 1 hour
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jun 2026
- Study start1 Dec 2024
- Primary completion1 Jun 2026
- Study completion5 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Anterior Shoulder DislocationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants were randomly assigned in a 1:1 ratio to undergo closed reduction using either the standard Cunningham technique or the modified Cunningham technique.
- Masking
- None (open label)
- Enrolment
- 64 participants (actual)
Sponsor and investigators
- Lead sponsor
- Antalya Health Sciences University
- Sponsor type
- University, hospital or other
- Collaborators
- Akdeniz University Hospital
- Responsible party
- Principal investigator, Murat Duyan, Antalya Health Sciences University
- Investigators
- MURAT DUYAN, Principal investigator, University of Health Sciences, Antalya Training and Research HospitalSULEYMAN IBZE, ASSISTANT PROFESSOR, Study chair, Akdeniz universty
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07652671
- Sponsor's protocol ID
- 775
- Status last verified
- Jun 2026
- First submitted
- 8 Jun 2026
- Last updated
- 17 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared publicly due to participant confidentiality and ethical restrictions. De-identified aggregate study results may be reported in scientific publications.
Publications
Cunningham NJ. Techniques for reduction of anteroinferior shoulder dislocation. Emerg Med Australas. 2005 Oct-Dec;17(5-6):463-71. doi: 10.1111/j.1742-6723.2005.00778.x.
PubMed 16302939Cunningham N. A new drug free technique for reducing anterior shoulder dislocations. Emerg Med (Fremantle). 2003 Oct-Dec;15(5-6):521-4. doi: 10.1046/j.1442-2026.2003.00512.x.
PubMed 14992071Riebel GD, McCabe JB. Anterior shoulder dislocation: a review of reduction techniques. Am J Emerg Med. 1991 Mar;9(2):180-8. doi: 10.1016/0735-6757(91)90187-o. No abstract available.
PubMed 1994950Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation. Ann R Coll Surg Engl. 2009 Jan;91(1):2-7. doi: 10.1308/003588409X359123.
PubMed 19126329
Study at a glance
From the registry record, last updated by the sponsor on 17 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Standard Cunningham Technique and the Modified Cunningham Technique in Terms of Reduction Success and Emergency Department Discharge Time in Patients With Anterior Shoulder Dislocation: A Two-Center Prospective Randomized Study
- ClinicalTrials.gov ID
- NCT07652671
- Acronym / sponsor ID
- 775
- Keywords
- Anterior Shoulder Dislocation, Closed reduction, Modified Cunningham technique, Emergency department, Shoulder dislocation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 64 participants (actual)
- Lead sponsor
- Antalya Health Sciences UniversityUniversity, hospital or other
- Collaborators
- Akdeniz University Hospital
- Study start
- 1 Dec 2024 (actual)
- Primary completion
- 1 Jun 2026 (actual)
- Study completion
- 5 Jun 2026 (actual)
- First posted
- 17 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Anterior shoulder dislocation is a common emergency condition that usually requires closed reduction in the emergency department. Several reduction techniques are used in clinical practice, and the ideal method should be effective, fast, easy to perform, well tolerated by the patient, and associated with a low need for sedation.
This two-center prospective randomized study compares the standard Cunningham technique with a modified Cunningham technique in adult patients presenting to the emergency department with anterior shoulder dislocation. Eligible patients were randomly assigned to one of two groups: standard Cunningham technique or modified Cunningham technique.
The main aim of the study is to compare the success rate of shoulder reduction between the two techniques. Secondary aims include comparing reduction time, pain level measured by the Visual Analog Scale, need for additional reduction maneuvers, need for sedation, emergency department discharge time, and procedure-related complications.
The study is designed to determine whether the modified Cunningham technique can provide faster and more successful shoulder reduction without increasing patient discomfort or complication risk.
Detailed description
Anterior shoulder dislocation is one of the most common joint dislocations encountered in emergency departments. Closed reduction is the standard initial treatment in suitable patients. Although several reduction techniques are available, many methods require traction, patient tolerance, analgesia, or procedural sedation. These factors may prolong the reduction process, increase emergency department workload, and expose patients to sedation-related risks.
The Cunningham technique is a seated, patient-cooperation-based shoulder reduction method that aims to facilitate reduction by relaxation of the shoulder girdle muscles and massage of the biceps, deltoid, and trapezius muscles. The modified Cunningham technique used in this study preserves the basic principles of the standard technique but adds a controlled positioning maneuver. In the modified technique, the patient's affected hand is placed on the volar aspect of the physician's elbow, while the physician supports the patient's elbow and applies gentle downward pressure to the antecubital region together with muscle massage. This modification is intended to provide better control of the extremity, facilitate muscle relaxation, and support reduction without forceful traction.
This was a two-center, prospective, randomized, open-label, parallel-group study conducted in emergency department settings. Adult patients presenting with acute anterior shoulder dislocation were evaluated for eligibility. Patients meeting the inclusion criteria were randomly assigned to undergo closed reduction using either the standard Cunningham technique or the modified Cunningham technique.
The reduction procedure was performed by emergency physicians according to the assigned technique. Reduction success was assessed clinically and confirmed by post-reduction radiographic imaging when clinically appropriate. In patients in whom the assigned initial technique was unsuccessful, further management, including additional reduction maneuvers, procedural sedation, or orthopedic consultation, was performed according to routine clinical practice.
The study was designed to evaluate whether the modified Cunningham technique improves the clinical efficiency of anterior shoulder dislocation reduction in the emergency department without increasing pain or procedure-related complications. No investigational drug, biological product, or medical device was used in this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants were randomly assigned in a 1:1 ratio to undergo closed reduction using either the standard Cunningham technique or the modified Cunningham technique.
| Arm | Type | Receives |
|---|---|---|
| Standard Cunningham Technique | Active comparator | Procedure: Standard Cunningham TechniqueParticipants in this arm underwent closed reduction of anterior shoulder dislocation using the standard Cunningham technique. The patient was placed in a seated position, and reduction was attempted through patient relaxation and massage of the biceps, deltoid, and trapezius muscles without forceful traction. |
| Modified Cunningham Technique | Experimental | Procedure: Modified Cunningham Techniquearticipants in this arm underwent closed reduction of anterior shoulder dislocation using the modified Cunningham technique. The patient was placed in a seated position, and the affected hand was positioned on the volar aspect of the physician's elbow. The physician supported the patient's elbow and applied gentle downward pressure to the antecubital region while performing massage of the biceps, deltoid, and trapezius muscles to facilitate reduction without forceful traction. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Age 18 years or older
- Presentation to the emergency department with acute anterior shoulder dislocation
- Diagnosis of anterior shoulder dislocation confirmed by clinical examination and radiographic imaging
- Conscious and cooperative patients who are able to comply with the seated reduction procedure
- No associated mechanical pathology such as fracture, open wound, laceration, foreign body, or other traumatic condition preventing closed reduction
Key exclusion criteria (12 listed)
- Refusal to participate in the study
- Missing or unavailable study data
- Posterior or inferior shoulder dislocation
- Fracture-dislocation or associated fracture
- Open shoulder injury or significant laceration
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Standard Cunningham TechniqueClosed reduction of anterior shoulder dislocation using the standard Cunningham technique. The participant is seated, the affected upper extremity is supported in adduction and elbow flexion, and the physician applies massage to the biceps, deltoid, and trapezius muscles to facilitate muscle relaxation and shoulder reduction without forceful traction. | Procedure or surgery | Standard Cunningham Technique |
| Modified Cunningham TechniqueClosed reduction of anterior shoulder dislocation using the modified Cunningham technique. The participant is seated, and the affected hand is placed on the volar aspect of the physician's elbow. The physician supports the participant's elbow and applies gentle downward pressure to the antecubital region while performing massage of the biceps, deltoid, and trapezius muscles to facilitate reduction without forceful traction. | Procedure or surgery | Modified Cunningham Technique |
Primary outcome
Successful Shoulder Reduction Rate
Time frame: 1 hour
Success rate of anterior shoulder dislocation with modified Cunningham reduction technique
6 secondary outcomes
Reduction Time
Time frame: 1 hour
Procedure-Related Pain Score
Time frame: 1 hour
Need for Additional Reduction Maneuver
Time frame: 1 hour
Need for Procedural Sedation
Time frame: 1 hour
Emergency Department Discharge Time
Time frame: Procedure-Related Complications
Procedure-Related Complications
Time frame: 1 hour
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Jun 2026.
- Background: PubMed 16302939Cunningham NJ. Techniques for reduction of anteroinferior shoulder dislocation. Emerg Med Australas. 2005 Oct-Dec;17(5-6):463-71. doi: 10.1111/j.1742-6723.2005.00778.x.
- Background: PubMed 14992071Cunningham N. A new drug free technique for reducing anterior shoulder dislocations. Emerg Med (Fremantle). 2003 Oct-Dec;15(5-6):521-4. doi: 10.1046/j.1442-2026.2003.00512.x.
- Background: PubMed 1994950Riebel GD, McCabe JB. Anterior shoulder dislocation: a review of reduction techniques. Am J Emerg Med. 1991 Mar;9(2):180-8. doi: 10.1016/0735-6757(91)90187-o. No abstract available.
- Background: PubMed 19126329Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation. Ann R Coll Surg Engl. 2009 Jan;91(1):2-7. doi: 10.1308/003588409X359123.
- Individual participant dataSharing planned: No. Individual participant data will not be shared publicly due to participant confidentiality and ethical restrictions. De-identified aggregate study results may be reported in scientific publications.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
MURAT DUYAN principal investigator
University of Health Sciences, Antalya Training and Research Hospital
SULEYMAN IBZE, ASSISTANT PROFESSOR study chair
Akdeniz universty
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Standard Cunningham Technique and Modified Cunningham Technique in people with Anterior Shoulder Dislocation and Closed Reduction, run by Antalya Health Sciences University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Successful Shoulder Reduction Rate (time frame: 1 hour). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07652671, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jun 2026.