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A difference is the treatment of urgency, ie, pursuing the engagement of the joint, and the definitive treatment, which attempts to prevent future dislocations.

Emergency treatment consists of a series of specific maneuvers traction and lateral rotation of the limb, which fit the shoulder, that is, reduce it.

If the patient working several attempts may be made gentle reduction. If there is much reduced or contracture be repeated under short general anesthesia, so it is not required intubation of the patient, ie the placement of a tube into the trachea to inflate the lungs (ventilation machine).

What you should do is insist on attempts to reduce the conscious patient, because it can cause a fracture or neurological injury, or cartilage. Not worth avoiding anesthesia if all you get is going to worsen the picture.Once reduced, placing a sling for three weeks, followed by progressive exercises for mobility and strength, which sometimes require the help of a physiotherapist. Movements that cause the dislocation should be banned for a while.

Patients with dislocation “recurrent,” ie, those with more than a dislocation, are often candidates for surgery.

The techniques employed seek to stabilize the joint, either by tightening the capsule, increasing the height of the rim of the glenoid, and so on.

In young people with three or fewer episodes of anterior dislocation surgery may be attempted by arthroscopy. In patients with multiple episodes of increased security is achieved with traditional surgery, called open.

The recurrent posterior dislocations no consensus on the best technique possible, as limited published series of patients operated.

credit to: Dr. Roberto Palacio González, Dr. Alain Vannineuse

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