Dislocation Reduction of the Shoulder Joint (Emergency Medicine)

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  • Anterior shoulder dislocations
  • Posterior dislocations
  • Other dislocations
    • Inferior dislocations of the shoulder, known as luxatio erecta

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

  • 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.

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  • Recheck the neurovascular status.
  • Confirm reduction of the dislocation.
  • Obtain postreduction radiographs.
  • Immobilize the reduced shoulder.
  • Arrange orthopaedic evaluation.
  • Prescribe appropriate analgesia.
  • 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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