How is traction applied for the reduction of shoulder dislocation?

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

Traction should be applied in a gentle, smooth, firm manner for several minutes, until reduction is attained. Patience is rewarded; yanking, placing the operator’s foot in the patient’s axilla, or other impatient maneuvers will only increase the likelihood of complications. At reduction, the affected arm is usually lengthened and relaxed, with an audible clunk. Slight external rotation may ease reduction. [7]

In a patient with a posterior dislocation, an assistant may apply additional gentle pressure to the humeral head in the posterior [7, 9]  and lateral [9, 48] directions to disengage it from the posterior glenoid. When the head of the humerus disengages, the arm may be externally rotated. However, the operator must exercise extreme caution here because external rotation can cause a fracture of the humerus if the head is not disengaged from the glenoid. [49]


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