Closed reduction (see techniques below)
Note: do not reduce chronic dislocations (>4 weeks) in the ED due to risk of arterial injury
Consult orthopedics for cautious attempt at closed reduction or open reduction
Procedural sedation often required
Consider intra-articular lidocaine (10-20mL) as alternative to procedural sedation
Note: do not reduce chronic dislocations (>4 weeks) in the ED due to risk of arterial injury
Consult orthopedics for cautious attempt at closed reduction or open reduction
Consult orthopedics for cautious attempt at closed reduction or open reduction
Consider intra-articular lidocaine (10-20mL) as alternative to procedural sedation
FARES (Fast, Reliable, and Safe) Method:
Cunningham Technique: video and second video
Davos Technique,:
Neck extension creates traction on the injured shoulder, which allows it to reduce
Snowbird Technique
Kocher: video
Note that a modified Kocher technique avoids abduction and internal rotation and reduces the dislocated shoulder through external rotation alone
Milch
Scapular manipulation
Stimson
Note that this is not an ideal technique as it requires a sedated patient to lay face-down, potentially leading to suffocation on the exam table
Traction-Countertraction
Anterior shoulder dislocation
Traumatic/Acute:
Posterior shoulder dislocation
Shoulder Dislocation
Shoulder dislocation
Inferior shoulder dislocation
Acromioclavicular joint injury
Sternoclavicular dislocation