Which exams are performed prior to attempting reduction of anterior shoulder dislocations?

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

Before any attempts at reduction, the provider should perform a neurovascular examination and assess the probability of a fracture, considering the mechanism of injury and the physical characteristics of the patient. The axillary nerve is the most commonly injured nerve in shoulder dislocations and can be evaluated by testing for sensation in the lateral upper arm and by palpating for contraction of the deltoid muscle while the patient abducts against resistance. The clinician should also look for possible damage to other branches of the brachial plexus.

Arterial injury, though rare in this setting, is also possible and can present with paresthesias, diminished pulse, paleness or coolness of the affected extremity, pain that is out of proportion to the physical findings, or paralysis. [7] Injury to the axillary artery is more common in the elderly population. [8]


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