Which injuries necessitate atraumatic reduction of anterior dislocation and avoidance of multiple attempts?

Updated: Aug 17, 2018
  • Author: Anantha K Mallia, DO, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Various neurovascular injuries and common fractures do not prohibit reduction but do call for prompt and atraumatic reduction with avoidance of multiple attempts. These include the following:

  • Nerve injuries - The brachial plexus, axillary nerve, or musculocutaneous nerve may be injured; neurapraxias (contusions of the nerve) usually resolve within weeks
  • Suspected major arterial injury - Urgent angiography is required
  • Common fractures - Hill-Sachs deformity, a compression fracture of the posterolateral aspect of the humeral head, and Bankart fracture, a detachment of the anterior aspect of the glenoid rim, may occur as the result of the dislocating force as the humeral head presses forcefully against the glenoid rim [7] ; avulsion fractures of the greater tuberosity of the humeral head tend to heal well but require immediate orthopedic consultation if the displacement exceeds 1 cm

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