How are shoulder dislocations treated?

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

In patients with shoulder dislocation, stabilize and treat associated trauma as indicated. Allow the patient to assume a position of comfort while maintaining cervical spine immobilization if necessary. A pillow between the patient's arm and torso may increase comfort. [34, 23]

Administer analgesics to decrease pain.

Prereduction and postreduction radiographs are recommended. Patients with frequent recurrent dislocations can safely avoid radiographs.

Procedural sedation and analgesia (PSA) protocols, intra-articular lidocaine, and ultrasound-guided brachial plexus nerve block assist in making reduction an easier and more comfortable procedure. Using US-guided interscalene block reduces time spent in the ED and lessens one-on-one health care provider time compared to procedural sedation. [35]

Immobilize the shoulder after reduction.

Perform careful prereduction and postreduction neurovascular examinations.

Orthopedic consultation may be helpful for dislocations with concomitant fractures, for posterior or inferior dislocations, and for cases in which the patient's shoulder cannot be reduced in a timely fashion.


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