Reduction of Shoulder Dislocation Questions & Answers

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

Overview

What is the most common large-joint dislocation seen in the emergency department (ED)?

What are the types of anterior dislocations?

What is the prevalence of posterior shoulder dislocations?

What is the prevalence of inferior glenohumeral dislocation (luxatio erecta humeri)?

How are shoulder dislocations reduced?

Which shoulder dislocations should be referred to an orthopedic surgeon for correction?

What are the indications for closed reduction of posterior shoulder dislocations?

What are the indications for closed reduction of inferior glenohumeral dislocations?

When is standard closed reduction of an anterior shoulder dislocation contraindicated?

Which injuries necessitate atraumatic reduction of anterior dislocation and avoidance of multiple attempts?

What are the contraindications for standard closed reduction of a posterior shoulder dislocations?

What are the contraindications for standard closed reduction of an inferior glenohumeral dislocation?

How is the reduction approach determined for shoulder dislocation?

What is the clinical presentation of anterior shoulder dislocation?

Which exams are performed prior to attempting reduction of anterior shoulder dislocations?

What causes posterior shoulder dislocations?

Which exams are performed prior to attempting reduction of posterior shoulder dislocations?

What is the clinical presentation of inferior glenohumeral dislocations?

When is open reduction considered for anterior shoulder dislocations?

How can injuries be prevented during reduction of shoulder dislocation?

What is the most common adverse outcome after reduction of shoulder dislocation?

What are the possible complications of shoulder dislocations?

Which injuries are associated with inferior glenohumeral dislocations?

Periprocedural Care

What is the role of radiography in in the assessment of anterior shoulder dislocation?

Which factors have been associated with clinically significant fractures in shoulder dislocations?

What is the role of ultrasonography in the diagnosis of shoulder dislocation?

How are posterior shoulder dislocations diagnosed?

What are the limitations of a radiography AP view when evaluating posterior shoulder dislocations?

Which radiographic views should be used to diagnose posterior shoulder dislocations?

What is the clinical presentation of posterior shoulder dislocation?

Which exams should be performed prior to an attempted reduction of an inferior shoulder dislocations?

What is the clinical presentation suggestive of an inferior shoulder dislocation?

Which radiograph views should be obtained for evaluation of inferior shoulder dislocations?

Which equipment is required for the reduction of shoulder dislocations?

When are pain control and muscle relaxation indicated for reduction of dislocated shoulders?

What are the pain control options for reduction of anterior shoulder dislocation?

When is procedural sedation used in reduction of shoulder dislocations?

How is intra-articular anesthetic injection performed in the reduction of shoulder dislocations?

What are the advantages of intra-articular anesthetic injection in the reduction of shoulder dislocations?

What is the efficacy of intra-articular lidocaine in the reduction of shoulder dislocations?

What is the disadvantage of intra-articular anesthetic injections in reductions of shoulder dislocations?

What is the role of brachial plexus nerve blocks in the treatment of shoulder dislocations?

How are nerve blocks performed in the reduction of shoulder dislocations?

What are the advantages of nerve blocks over procedural sedation in the reduction of shoulder dislocations?

What are the disadvantages of nerve blocks over procedural sedation in the reduction of shoulder dislocations?

What are the indications for procedural sedation and analgesia during reduction of posterior shoulder dislocations?

How is pain controlled during reduction of an inferior shoulder dislocation?

How is the degree of anesthesia determined for the reduction of inferior shoulder dislocations?

Which patients are more likely to require higher levels of analgesia, muscle relaxation, or procedural sedation for reduction of an inferior shoulder dislocation?

Which non-patient-related factors affect the choice of an anesthesia in the reduction of shoulder dislocations?

Technique

Which factors may vary among reduction techniques for shoulder dislocations?

Which techniques are commonly used to reduce anterior shoulder dislocations?

How are posterior shoulder dislocations typically reduced?

Which techniques are commonly used to reduce inferior shoulder dislocations?

Which maneuvers facilitate most techniques for the reduction of shoulder dislocations?

What are the signs of successful reduction of shoulder dislocations?

What information should be the patient receive prior to giving informed consent for reduction of shoulder dislocations?

Why is neurovascular exam required before and after reduction of shoulder dislocations?

When is orthopedic consultation necessary for the reduction of shoulder dislocations?

How is the Stimson maneuver performed for the reduction of shoulder dislocations?

What can facilitates the reduction of shoulder dislocations during a Stimson maneuver?

What are the advantages of the Stimson maneuver for the reduction of shoulder dislocations?

What are the disadvantages of the Stimson maneuver for the reduction of shoulder dislocations?

How is scapular manipulation performed for the reduction of shoulder dislocations?

What are the advantages of scapular manipulation for the reduction of shoulder dislocation?

What are the disadvantages of scapular manipulation for the reduction of shoulder dislocation?

How is external rotation performed for the reduction of shoulder dislocation?

What are the advantages of external rotation for the reduction of shoulder dislocation?

What are the disadvantages of external rotation for the reduction of shoulder dislocation?

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

What are the advantages of the Milch technique for the reduction of shoulder dislocation?

What are the disadvantages of the Milch technique for the reduction of shoulder dislocation?

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

What are the advantages of the Spaso technique for the reduction of shoulder dislocation?

What are the disadvantages of the Spaso technique for the reduction of shoulder dislocation?

How is the traction-countertraction technique performed for the reduction of shoulder dislocation?

How is traction applied for the reduction of shoulder dislocation?

How does joint stability affect posttreatment following traction-countertraction for the reduction of shoulder dislocation?

What are the advantages of the traction-countertraction technique for the reduction of shoulder dislocation?

What are the disadvantages of the traction-countertraction technique for the reduction of shoulder dislocation?

How is the axial (inline) traction technique performed for the reduction of shoulder dislocation?

How is the two-step reduction technique performed for the reduction of shoulder dislocation?

Medications

Which medications in the drug class Opioid Analgesics are used in the treatment of Reduction of Shoulder Dislocation?

Which medications in the drug class Anesthetic Agents are used in the treatment of Reduction of Shoulder Dislocation?

Which medications in the drug class Local Anesthetics, Amides are used in the treatment of Reduction of Shoulder Dislocation?

Which medications in the drug class Anxiolytics, Benzodiazepines are used in the treatment of Reduction of Shoulder Dislocation?