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Anterior Shoulder Dislocation Reduction

The human body is an amazing machine, both in design and performance. The body also comes with a series of checks and balances, meaning some its greatest assets tend to include inherent weaknesses. Our highly usable and free moving joints may be capable of performing tasks in variety of motions, but are often the most vulnerable to injury. The shoulder joints are a perfect example of this, and in the event of injury, sometimes serious surgical procedures are needed to repair the damage and promote movement.

  1. The Shoulder Joint

    • The shoulder joints are a typical ball and socket style joint that allows movement around a fixed point, in this case the glenohumeral joint. When the ball (the head of the humerus) comes out of the socket (the glenoid fossa), dislocation occurs; this dislocation can be either on the anterior (front) of the shoulder or the posterior (rear). Anterior dislocation accounts for nearly all patients who visit the emergency room complaining of shoulder pain and make up almost 2 percent of all ER visits, and is more common in children than adults due to weakened bones and cartilage.

    Reduction Treatment

    • Treatment for shoulder dislocation is called shoulder reduction, which simply means resetting the shoulder back into its proper location. This procedure, which may vary according to attending health professional as there are several common methods, involves applying gentle yet forceful pressure (with a little leverage) to get the ball into the socket. This may be attempted several times, and depending on the severity of the pain the patient may be mildly sedated.

    A Sample Method

    • One of the most commonly taught methods of shoulder reduction is known as the Kocher Method. The physician externally rotates the patient's arm so that the patient's palm faces up. The arm is held out from the patient's side, followed by the physician sliding the elbow along the chest to center with the patient's midline. With enough leverage, the humeral head is reinserted into the socket.

    Alternative Method

    • The Milch Method has the physician actively bringing the patient's arm above her head as she lies flat on a table or bench. The physician uses his thumb to add stability before applying traction on the arm. The patient's arm is flexed to 90 degrees as the physician applies pressure with his thumb, thus sliding the head of the humerus into the socket. In some cases, the flexed arm is placed behind the patient's head to increase the amount of traction and decrease the amount of pressure needed to reduce the shoulder.

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