I must confess I was hoping someone else would say
they didnt know what the Belsher technique was before
I had to.
It turns out though Ive been doing this same technique
for several years, using relaxation techniques I
picked up doing a hypnosis course. I have never got
above a 30-40% success rate though, unless extremely
careful about 'patient selection'. Some of the
problems in delay and x ray can be solved by walking
the patient round to x ray from triage then doing the
reduction in the x ray room. It certainly surprises
the radiographer when you ask for a postreduction
film.
Do those of you advocating this, honestly, with your
mits on your bits, get ALL your shoulders back this
way, without analgesia? If so I must be crap at it -
the problem I have is that even very slowly, it does
hurt and some people it seems just can't relax
whatever you do.
Steve Meek
Bath
--- Adrian Fogarty <[log in to unmask]> wrote:
> ----- Original Message -----
> From: "Paul Ransom"
> Subject: Re: Flumazenil, Sedation and Fits
> > For those of us out of the country last year, or
> having an off day during
> > that posting, what exactly is the 'Belsham
> technique'? I remain to be
> > convinced about the analgesia free reduction.
>
> OK here goes, it's actually Kocher's original
> technique described in the
> late 19th century and Phil loves to show me the
> original German transcript!
>
> Firstly, NO traction allowed.
>
> Hold the flexed elbow close to the patient's side
> i.e. adducted with the
> forearm pointing to the roof (supine patient).
>
> Then slowly externally rotate the humerus - this bit
> takes ages - all the
> while keeping that elbow close to the patient's
> side.
>
> When the forearm reaches the horizontal position
> (i.e. the humerus is now 90
> degrees externally rotated), slowly flex the
> humerus, keeping the forearm
> externally rotated throughout.
>
> At full flexion of the humerus, you should now
> internally rotate the arm,
> and lo and behold the joint is back in!
>
> It's a bizarre experience, cos you can't really see
> where or when the
> reduction occurred. I think you need an intact
> humeral head for it i.e. no
> fractures allowed. Phil will let us know anything
> I've missed out, I'm sure,
> and he's got some neat pictures describing the
> anatomical basis of the
> technique. I'm not so patient so I sometimes use a
> little sedation/analgesia
> but I still like the technique itself - it's very
> "drug sparing" so to
> speak.
>
> Adrian Fogarty
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