Management of Acute Anterior Shoulder Dislocations: On & Off the Field

This panel discusses the management of acute anterior shoulder dislocation: on and off the field with Grante Norte, Angela West, Michael Gnaciski and Dr. Peter Millett. Michael Gnaciski discusses shoulder dislocations.

This panel discusses glenohumeral dislocations, the anatomy and biomechanics, acute management on the field and post-reduction and the treatment options. For general shoulder injuries, the medical team must listen to the athlete for what their main complain in symptoms. Injuries can include imbalance, overuse, separations, tears and dislocations and subluxations. 50% of all shoulder dislocations are glenohumeral. Not only is it the most common, but it is the most traumatic. 90-98% of the glenohumeral dislocations occur anteriorly.

Epidemiology - fewer studies have reported on incidence of glenohumeral dislocations. According to research, over the last 23 years glenohumeral dislocations have nearly doubled which is most likely due to greater population size and a greater number of athletes participating in high impact sports. In high school athletes from 2005 to 2007 shoulder dislocations accounted for 23.7% of all shoulder injuries, which is second to sprains and strains. These injuries were most commonly seen in girls basketball, boys' soccer, football and wrestling. At the collegiate level, studies showed that shoulder dislocations were mostly commonly seen in men's ice hockey, wrestling, football and women's volleyball.

Some of the concerns associated with a shoulder dislocation is a timely reduction, sequelae of injury and recurrent episodes. Secondarily, you need to take into consideration the cost and time, the pain level and the potential decreased quality of life.

Athletic trainers are commonly the first health care professional on-site. The goal is a safe and timely management of the injury. There is an issues with a lack of continuity within acute management. Achieving a gold standard is key. The current research efforts are on acute management.

The purpose of this talk is to provide a guideline for healthcare professionals, describe the safest techniques according to current literature and to establish continuity in management of acute anterior glenohumeral dislocations and to improve patient-oriented outcomes.