Radiographic evaluation of anterior dislocation of the shoulder

PURPOSE: To establish radiographic criteria to choose the most appropriate technique of reduction for each type of anterior glenohumeral dislocation, and to determine the type of dislocation which requires general anesthesia. MATERIAL AND METHODS: Radiography in two different projections was performed in 67 patients with antero-inferior shoulder dislocations before a reduction attempt. The method proposed by BOss-HOLZACH-MATTER was used as the primary technique for all shoulder dislocations. RESULTS: Most subcoracoid dislocations (84.4%) could be reduced by the BOss-HOLZACH-MATTER method while only a few subglenoid dislocations (15.8%) were reducible by this technique. Displaced associated fractures significantly reduced the success rate of the reduction attempts. CONCLUSION: Anterior dislocations of the shoulder require different methods of reduction depending upon the type (sub-group) of dislocation. Reduction of subglenoid dislocations with associated greater tuberosity fracture should be performed under general anesthesia to avoid head-splitting fracture.