• Inability to reduce the shoulder.
• Additional damage to the humeral head, glenoid, or labrum during
the reduction maneuver.
• Traction injury to the brachial plexus and especially the axillary
• An adequate level of conscious sedation is critical.
The patient must have muscle relaxation and should not be “fighting” the
• Do not let go once traction is applied to the arm.
• Continuous traction helps relax the muscles that may be holding
the humeral head out of the glenoid fossa in a shortened position.
• Perform and document a neurovascular examination both before
attempting reduction and after the reduction.
Applying traction to shoulder.
• Obtain radiographs (2 views) to confirm the reduction.
• The patient is placed in a shoulder immobilizer.
• If an immobilizer is not available, a sling with an elastic bandage
wrap holding the ...
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