Contraindications to Scapular Manipulation Contraindications to simple closed reduction: Greater tuberosity fracture with > 1 cm displacement Significant Hill-Sachs deformity (≥ 20% humeral head deformity due to impaction against glenoid rim) Surgical neck fracture (below the greater and lesser tuberosities) Bankart fracture (anteroinferior glenoid rim) involving a bone fragment of over 20% and with glenohumeral instability Proximal humeral fracture of 2 or more parts These significant associated fractures require orthopedic evaluation and management, because of the risk of the procedure itself increasing displacement and injury severity.