Treatment

Patients should be referred to the emergency department for prompt reduction under adequate muscular relaxation (1).

Management strategy may vary according to duration of dislocation, the size of the humeral head impression defect, the presence of fracture and on the patient's age, health and functional status

• non operative
  • closed reduction
    • should be attempted in acute cases (less than 3 weeks)
    • by pulling the arm and laterally rotating it, whilst the head of the humerus is pushed forwards
    • once reduced the stability of the shoulder is assessed
      • if stable in internal rotation, immobilise arm in a sling in neutral rotation for three weeks
      • if unstable, immobilise arm at the side and in external rotation of 20˚ for six weeks
    • if closed reduction is not successful, open reduction is performed
• operative
  • arthroscopic approach
  • open reduction

Reference:

• (1) Jacobs RC, Meredyth NA, Michelson JD. Posterior shoulder dislocations. BMJ. 2015;350:h75.
• (2) Cicak N. Posterior dislocation of the shoulder. J Bone Joint Surg Br. 2004;86(3):324-32.