Yet Another Shoulder Dislocation

No series on dislocations would be complete without mentioning shoulder dislocation. Most shoulder dislocations (>90%) are anterior (forward), and it should be noted that shoulder dislocations make up about half of all dislocations seen in the ED. Most shoulders can be relocated easily, while others may frustrate a provider. Associated fractures, artery or nerve compromise, and even rotator cuff injuries can worsen the situation. Relocation techniques can be difficult, and may be physically challenging for the provider and patient.   Acute shoulder dislocation with fracture of tuberosity. (Photo by James Roberts)   This month we will briefly touch on one of the many techniques used to relocate a shoulder, and ask that you try it. We are going to skip the anatomy, and get right to the heart of the matter. If you have not come across a shoulder dislocation (or 100+) in your practice, then you are not seeing enough patients!   Many techniques are available to choose from when confronted with a problematic shoulder. In fact, here is a short (and probably incomplete) list if you need a refresher.• Milch (if you’re in the mood to go apple picking).• Stimson (if your patient is drunk, and you are busy).• Spaso (if you’re an Aussie).• Cunningham (if you like a more soothing, touchy-feely method).• Scapular manipulation (if you have the strength and patience and you have a buddy).• Traction/countertraction (if you have someone to hold the sheet; our person...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs