Prompt and appropriate treatment of an acute dislocated shoulder can minimise risk for future dislocations as well as the effects of related bone, muscle and nerve injuries, according to a literature review appearing in the December issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).
In 2011, shoulder dislocations accounted for 175,641 emergency department visits in the USA, although some patients chose to reset the joint without any medical assistance.
“We do not recommend self-setting of shoulder dislocations,” says Richelle Takemoto, an orthopaedic surgeon with Kauai Medical Clinic/Wilcox Memorial Hospital in Hawaii. Takemoto and her co-authors recommend immediate medical attention for a dislocated shoulder that includes radiographic images before and after reduction to check for related fractures and other musculoskeletal injuries.
The cause of injury, the presence of an associated fracture and or nerve injury, and the difficulty in resetting the shoulder all contribute to a patient’s outcome.
“Acute shoulder dislocations can be effectively managed by closed reduction manoeuvres,” says lead study author Thomas Youm, clinical assistant professor at the New York University Hospital for Joint Diseases. “There are a plethora of closed reduction techniques available for relocation of a dislocated shoulder. A thorough understanding of these reduction techniques as well as immobilisation strategy and rehabilitation regimes can successfully treat dislocations of the shoulder and hopefully prevent the need for surgery.”
References
Youm, T., Takemoto, R. & Kyu-Hong Park, B. (2014) Acute management of shoulder dislocations. J. Am. Acad. Orthop. Surg. 22, 761–771. doi:10.5435/JAAOS-22-12-761
