Management of acute anterior shoulder dislocation

Abstract

Shoulder dislocation is the most common large joint dislocation in the body. Recent advances in radiological imaging and shoulder surgery have shown the potential dangers of traditional reduction techniques such as the Kocher's and the Hippocratic methods, which are still advocated by many textbooks. Many non-specialists continue to use these techniques, unaware of their potential risks. This article reviews the clinical and radiographic presentation of dislocation; some common reduction techniques; their risks and success rate; analgesia methods to facilitate the reduction; and postreduction management. Many textbooks advocate methods that have been superceded by safer alternatives. Trainees should learn better and safer relocation methods backed up by the current evidence available.

Simultaneous Bilateral Anterior Dislocation of Glenohumeral Joint in Elderly Patients with Seizures: A Case Report

“…In international literature numerous techniques have been described but there is a conflict about which is the more effective one [13]. Techniques of reduction of dislocated shoulder are classified in two categories: leverage (Kocher, Milchs, Cunningham technique) and traction (Hippocrates, Stimson, Eskimo, Spaso, Scapular manipulation technique, Fares method) [14]. All these techniques have advantages and disadvantages.…”

Shoulder instability: A myriad of decisions for optimal emergency department care

“…Multiple methods for reduction of shoulder dislocation have been described (Cunningham, 2005), however it has been suggested that the optimal technique should be quick, effective, simple to perform and should require minimal force, analgesia and assistance (Dala-Ali et al, 2014).…”

Predicting recurrent shoulder instability

“…First, sideline clinicians should be expert at relocating shoulders with appropriate precautions 2. In the office consultation, factors providing high risk of recurrent instability include: age of 20 years, bony pathology such as large glenoid fractures or Hill-Sachs lesions, generalised ligamentous laxity, and participation in high-risk sport such as collision sports.…”