Management of acute anterior shoulder dislocation

Br J Sports Med. 2014 Aug;48(16):1209-15. doi: 10.1136/bjsports-2012-091300. Epub 2012 Jul 21.


Shoulder dislocation is the most common large joint dislocation in the body. Recent advances in radiological imaging and shoulder surgery have shown the potential dangers of traditional reduction techniques such as the Kocher's and the Hippocratic methods, which are still advocated by many textbooks. Many non-specialists continue to use these techniques, unaware of their potential risks. This article reviews the clinical and radiographic presentation of dislocation; some common reduction techniques; their risks and success rate; analgesia methods to facilitate the reduction; and postreduction management. Many textbooks advocate methods that have been superceded by safer alternatives. Trainees should learn better and safer relocation methods backed up by the current evidence available.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Anesthetics, Combined / therapeutic use
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Immobilization / methods
  • Manipulation, Orthopedic / methods
  • Nitrous Oxide / therapeutic use
  • Oxygen / therapeutic use
  • Physical Examination / methods
  • Radiography
  • Referral and Consultation
  • Shoulder Dislocation / diagnostic imaging
  • Shoulder Dislocation / therapy*
  • Traction / methods


  • Analgesics
  • Anesthetics, Combined
  • Hypnotics and Sedatives
  • Entonox
  • Nitrous Oxide
  • Oxygen