Anterior Shoulder Dislocation - ED Management The shoulder is the most commonly dislocated major joint, 95% of shoulder dislocations occur anteriorly. Here’s a quick summary. • Most common major joint dislocation, 95% of shoulder dislocations occur anteriorly • Mechanism: Blow to abducted, externally rotated, extended arm • Exam: Loss of rounded appearance of shoulder; held in slight abduction & external rotation, resist movement • Possible associated injuries: Axillary nerve injury (40%, loss of sensation over deltoid), Hill-Sachs deformity (35-40%, cortical depression in the humeral head), greater tuberosity fracture (10%), bony Bankart lesions (5%, fracture of anterior inferior glenoid) • ED Management: Analgesia with intraarticular injection +/- procedural sedation and reduction • Splint: Sling-and-swath or shoulder immobilizer • Ortho consult: No (unless fracture, neurovascular injury, difficult reduction) • Disposition: DC with ortho follow-up within I week MH/CCF/CWRU EM Res @MetroHealth_EM #Shoulder #Dislocation #Anterior #Radiology #XRay #Diagnosis #Management #Orthopedics #Sports #MSK
