Orthopedics - Shoulder Dislocation
Orthopedics & Podiatry Main Menu
Complete displacement of the humeral head
from the glenoid fossa often caused by direct trauma. First time
dislocations may require external force for reduction. Severe dislocations
can have associated brachial plexopathies and vascular compromise.
Initial Diagnosis and Management
- History and physical
- Plain radiographs (AP and
lateral axillary, internal and external rotations).
- MRI/CT not indicated.
- Reduction should only be
performed by a medical specialist trained in this procedure.
- Immobilize the shoulder
for 2 weeks or until seen by therapist.
- Ice as needed for pain
- Appropriate activity
- 72-hour consult to
Physical Therapy (routine TRICARE Consult).
Ongoing Management and Objectives
In cases not requiring surgical
intervention, early mobilization and progressive rehabilitation usually
results in the ability to return to full activity within 10 weeks.
Indications for Specialty Care Referral
- Physical Therapy should
be consulted within 72 hours for acute and chronic dislocations if
radiographs are normal.
orthopedics for fractures, suspected fractures, radiographic evidence of
Bankart or Hill-Sachs lesion, neurologic or vascular compromise.
- Consult Orthopedic
Surgery if there is no or slower than expected resolution.
Criteria for Return to Primary Care
- Resolution of the acute
or chronic symptoms.
- Patient meets discharge