How is the axial (inline) traction technique performed 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

The patient is placed supine on a sturdy immobile surface (eg, a wheel-locked gurney). The physician, standing on the affected side at the patient’s head, [7]  applies axial traction in line with the abducted arm. To facilitate the procedure, an assistant can apply parallel countertraction by using a sheet wrapped diagonally over the affected shoulder. During the application of axial traction, increasing the degree of abduction (if possible) and applying cephalad pressure to the displaced humeral head can aid in reduction (see the image below).

Reduction of shoulder dislocation: axial traction Reduction of shoulder dislocation: axial traction and countertraction. Axial traction is applied to arm, and parallel countertraction is applied with sheet wrapped over shoulder. Increasing degree of abduction (if possible) and applying cephalad pressure to displaced humeral head (star) can aid in reduction.

After successful reduction of the humeral head, the arm should be fully adducted against the chest wall and supinated and immobilized in that position (see the image below).

Reduction of shoulder dislocation: axial traction Reduction of shoulder dislocation: axial traction and countertraction. After inferior dislocation is reduced, arm is adducted, supinated, and immobilized for postreduction radiography.

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