Reduction of anterior shoulder dislocation by external rotation

Abstract

AbstractObjective: To examine the efficacy of external rotation as initial treatment for anterior shoulder dislocation.Design: Prospective uncontrolled study of the efficacy and adverse effects of external rotation when used as the initial technique to reduce anterior shoulder dislocation.Results: Ninety two cases of anterior shoulder dislocation were treated over an 18 month period. External rotation was used successfully to reduce the dislocation in 72 cases (78%). A further nine cases were reduced by external rotation with the aid of traction (total 88%). Six of eight cases complicated by fracture of a humeral tuberosity were reduced by external rotation. Twenty six reductions were achieved without the use of analgesia. Two cases of nerve palsy were seen, both associated with the use of traction.Conclusions: External rotation is a simple and safe method of reduction for anterior dislocations of the shoulder. The technique is recommended as the initial reduction technique for anterior shoulder dislocations. The use of traction should be discouraged.