Assessment and management of shoulder dislocation

### What you need to know Shoulder dislocations are painful and have an impact on activities of daily living and participation in sports. Most shoulder dislocations (>95%) occur in the anterior direction and are usually the result of trauma.123 Optimal management can prevent recurrent dislocations and reduce social costs.456 Patients with first time dislocations often receive insufficient information to make a decision about their management.7 Shared decision making must take into consideration the patient’s preferences for surgery or physical therapy, their expectations, and the likelihood of recurrence.6 In this clinical update we present an initial approach for primary care and emergency healthcare providers to assess and manage patients with a traumatic anterior shoulder dislocation. More than 70% of shoulder dislocations occur in men.123 In a cohort study of 16 763 patients who experienced a first time anterior dislocation in the UK, peak incidence was in men aged 16-20 (80.5 per 100 000 person years) and in women aged 61-70 (28.6 per 100 000 person years).3 These peak incidences are similar in other Western countries, such as Canada, the US, and Norway.23 In young patients, shoulder dislocations …