Anterior shoulder dislocations
How to reduce the humerus
A 67 year old woman slipped on ice when she was shopping and landed on her outstretched arm. She developed immediate pain, swelling, and bruising over her right shoulder. No other injuries were found. Two radiographs were taken of her right shoulder (figs 1a and b).
Anterior glenohumeral dislocation is the commonest major joint dislocation seen in the emergency department, and yet it is often misdiagnosed and mismanaged.1 The incidence is estimated to be 12.3 per 100 000, and it represents 90% of all shoulder dislocations.2 An acute traumatic shoulder dislocation requires urgent treatment to prevent long term complications (box 1).
Shoulder dislocation affects both sexes and can occur at any age, but it has a bimodal distribution with 16-30 year old men having the highest risk. The other groups at risk are men and women over the age of 60, where dislocation is often caused by low energy falls.6 Box