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Management of shoulder dislocations

Accident & Emergency Department, University College Hospital, UCL Hospitals NHS Foundation Trust, London, UK, theodoroschristofi{at}hotmail.com

A. Kallis

Accident & Emergency Department, University College Hospital, UCL Hospitals NHS Foundation Trust, London, UK

D.A. Raptis

Department of Surgery, University College Hospital, UCL Hospitals NHS Foundation Trust, London, UK

M. Rowland

Accident & Emergency Department, University College Hospital, UCL Hospitals NHS Foundation Trust, London, UK

J. Ryan

Accident & Emergency Department, University College Hospital, UCL Hospitals NHS Foundation Trust, London, UK

Shoulder dislocations are seen on a daily basis in Accident and Emergency departments. The vast majority of these injuries are acute, traumatic dislocations and occur in the anterior direction. The clinical and radiological features of an anterior dislocation are fairly typical and the diagnosis is usually reached quickly. The sooner the joint is reduced, the easier will be required to overcome the muscle spasm. There is still no consensus as to the best way to manage these injuries in the emergency setting. We summarise the types of acute glenohumeral dislocations and the commonly used reduction methods for anterior dislocations. The literature about different analgesic and sedative options is also reviewed. Occasionally, a combination of sedatives and analgesics and more than one reduction technique are employed in order to avoid manipulation of the dislocated shoulder under general anaesthetic.

Key Words: shoulder dislocation • glenohumeral joint • reduction • sedation • analgesia

Trauma, Vol. 9, No. 1, 39-46 (2007)
DOI: 10.1177/1460408607083962


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