A shoulder dislocation may sometimes be treated at the scene of the injury, however, treatment at a hospital is a much safer option. If an experienced medical provider is nearby, then a shoulder dislocation can typically be easily reduced immediately after the injury, and before the muscles have gone into spasm. At that point in time, the shoulder dislocation can often be reduced with some basic manipulation.
It is important to remember that there are inherent complications of a shoulder dislocation, and additional complications in attempting to reduce a dislocated shoulder.
There are a variety of methods available to return the shoulder to its normal position. Once the patient arrives at the emergency room, they will receive either an intravenous (IV) sedation or a local injection prior to the reduction procedure.
In general, the aim of reduction is to effectively manipulate the bones to allow them to gently slide back into the correct position without causing further damage to the shoulder joint.
Once the dislocated shoulder is back in place, X-rays are taken to confirm the shoulder is in the correct position, as well as to check for other injuries such as fractures. Patients are then placed in a sling to rest and protect the shoulder from further injury, and referred to an orthopaedic surgeon for further management.
Once an individual sustains a shoulder dislocation, they are more likely to have a recurrence. This is a result of the fact that when a dislocation occurs, the shoulder ligaments are torn, and the shoulder joint has been rendered less stable. In most cases, a patient should be examined by their orthopaedic physician. The examiner will look for signs of injury to the ligaments of the shoulder—specifically, a Bankart lesion. In addition, the attending physician will order specific tests to evaluate for shoulder instability. An MRI examination may be obtained to check for the Bankart lesion. Commonly, the MRI is done with dye injected into the joint. If such ligament damage is discovered, a decision will need be made whether or not to proceed with surgical treatment.
If a patient has repeat shoulder dislocations, surgical treatment will often be recommended.