An interventional study of Standard Cunningham Technique and Modified Cunningham Technique in Anterior Shoulder Dislocation, Closed Reduction and Modified Cunningham Technique, sponsored by Antalya Health Sciences University. Completed at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-17.
Sponsored by Antalya Health Sciences University · Not applicable, Interventional, and Treatment
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.
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.
105 studies on the registry are indexed under Shoulder Dislocation; 22 are open to participants now.
This study's enrollment of 64 is close to the median of 60 across 71 interventional studies indexed under Shoulder Dislocation.
Browse Shoulder Dislocation studies →Antalya Health Sciences University is the lead sponsor of 18 studies on the registry; 10 are open to participants now.
Compared within Shoulder Dislocation, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Emergencies. The counts are of registry records indexed under each term, refreshed daily. How we classify →
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Procedure: Standard Cunningham Technique
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.
Procedure: Modified Cunningham Technique
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.
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.
Successful Shoulder Reduction Rate
Success rate of anterior shoulder dislocation with modified Cunningham reduction technique
Time frame: 1 hour
Reduction Time
The time elapsed from the initiation of the modified Cunningham reduction maneuver to clinical confirmation of shoulder reduction.
Time frame: 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)
Time frame: 1 hour
Need for Additional Reduction Maneuver
The proportion of participants who required an additional reduction maneuver after failure of the initially assigned technique.
Time frame: 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.
Time frame: 1 hour
Emergency Department Discharge Time
The time from emergency department admission to discharge from the emergency department, measured in minutes.
Time frame: 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.
Time frame: 1 hour
Plan to share: 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.
Ran from Dec 2024 to primary completion in Jun 2026, 18 months.
Of 39 non-industry interventional studies with no phase under Shoulder Dislocation, half reached primary completion within 22 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 39. This study's 18 months is below that.
Counting every sponsor, half of 39 studies reached it within 22 months; a quarter within 11 and three quarters within 39.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.
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Antalya Health Sciences University