Which physical findings are characteristic of anterior shoulder dislocation?

Updated: Nov 29, 2018
  • Author: Sharon R Wilson, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

Anterior shoulder dislocation (95-98% of ED dislocations):

  • Arm is held in slight abduction and external rotation.

  • Shoulder is "squared off" (ie, boxlike) with loss of deltoid contour compared with contralateral side.

  • Humeral head is palpable anteriorly (subcoracoid region, beneath the clavicle).

  • Patient resists abduction and internal rotation and is unable to touch the opposite shoulder.

  • Compare bilateral radial pulses to help rule out vascular injury.

  • In all cases, evaluate the axillary nerve before and after reduction by testing both pinprick sensation in the "regimental badge" area of the deltoid and palpable contraction of the deltoid during attempted abduction. Evaluate sensory and motor function of the musculocutaneous and radial nerves.


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