Dislocation Reduction of the Shoulder Joint (Emergency Medicine)

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SAMPLE EXCERPT
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PRE-PROCEDURE
INDICATIONS
  • Anterior shoulder dislocations
  • Posterior dislocations
  • Other dislocations
    • Inferior dislocations of the shoulder, known as luxatio erecta
CONTRAINDICATIONS

Shoulder dislocations require reduction; however, dislocation associated with humeral fracture may require open reduction.

ANATOMY
  • Humerus
    • The anatomic neck of the humerus is the boundary between the head of the humerus and the greater tubercle. The surgical neck is the area of the humerus that narrows just distal to the greater tubercle.
  • Scapula
    • The scapula articulates with the shoulder via the glenoid fossa and the acromion.
  • Neurovascular structures
    • The subclavian artery continues into the arm as the axillary artery and gives rise to several large branches in the shoulder, including the thoracoacromial, lateral thoracic, subscapular, and posterior circumflex humeral arteries.
    • The brachial plexus arises at nerve roots C5 through T1 and travels through the neck musculature and inferior to the clavicle into the arm through the axillary region.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Recheck the neurovascular status.
  • Confirm reduction of the dislocation.
  • Obtain postreduction radiographs.
  • Immobilize the reduced shoulder.
  • Arrange orthopaedic evaluation.
  • Prescribe appropriate analgesia.
COMPLICATIONS
  • Fractures of the humeral neck are frequently displaced with attempts at closed reduction and this often results in avascular necrosis of the humeral head.
  • Neurovascular injury
  • Joint instability and recurrent dislocation
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