Anterior shoulder dislocation

Abstract

Introduction: Anterior dislocation of the shoulder is commonly seen in accident and emergency (A&E) and trauma clinics. In this article, we review the existing literature on the injury and the recent trends in management.

Materials and methods: We have discussed this condition with our colleagues and performed a Medline search ('anterior shoulder dislocation') of the relevant papers. We also describe key historical publications and recent developments regarding immobilisation of the joint.

Results: Management decisions regarding this condition continue to vary between units, especially for recurrent and posterior dislocation. This paper lays some emphasis on the choice of analgesic agent when attempting shoulder reduction in the A&E setting. A summary of the data from our own department has provided a graphical representation of the classical age and sex distribution for this condition.

Conclusions: Shoulder dislocation is a common injury. Delays in diagnosis remain the single biggest obstacle to optimum results in this group of patients. A significant proportion will require eventual surgery and up to a third of these patients will go on to develop long-term shoulder arthritis. Even patients who have experienced a single episode of dislocation may go on to develop long-term sequelae.

Figures

Figure 1

An analysis of the age spectrum of patients admitted to Walsgrave A&E Department with shoulder dislocation over the last 3 years. The bulk of the patients are young adults. In spite of the depletion of the older cohort, there is an apparent second peak beyond the age of 60 years. Male patients clearly out-number women in the younger age group.