An emergency orthopedic procedure for acute joint dislocations — particularly of the shoulder, elbow and fingers — in which the joint is restored to its proper position with controlled manipulation.
Indication
- Acute anterior or posterior shoulder dislocation (glenohumeral dislocation)
- Elbow dislocation — simple (pure) or with associated fracture (complex)
- Finger interphalangeal joint dislocations (most often PIP)
- Hip dislocation (especially after prosthesis or high-energy trauma)
- Lateral patella (kneecap) dislocation
- Need for acute reduction in recurrent joint dislocations
Preparation
- Pre-reduction X-ray is essential — the presence of an associated fracture is evaluated
- Detailed neurovascular examination: pulse, skin color, sensation and motor function are recorded (important — e.g., axillary nerve at the shoulder, ulnar/median nerve at the elbow)
- Intravenous access is established; sedation or analgesia plan is prepared
- The patient is informed and written consent is obtained
- Sling/splint to be used after reduction is prepared
How it's performed
- Anesthesia options: local intra-articular injection, procedural sedation (IV), occasionally general anesthesia may be required
- For shoulder dislocation, atraumatic techniques are preferred: Stimson (prone with weight), Cunningham (with scapular manipulation), Spaso (gentle rotation-traction) or scapular manipulation — aggressive methods such as Hippocratic and Kocher are avoided
- For the elbow, slow longitudinal traction, forearm supination and gradual flexion of the elbow are applied
- In finger dislocations, gentle traction and flexion are used to relocate; usually successful with simple reduction
- After reduction, neurovascular examination is repeated
- Post-reduction control radiograph confirms the success of reduction and the presence of any accompanying fracture
Post-procedure
- Sling for 2-3 weeks after shoulder dislocation; followed by gradual physiotherapy (rotation-strengthening)
- Splint for 1-2 weeks after elbow reduction; early movement is initiated (to prevent stiffness)
- Buddy taping to the adjacent finger and early movement for finger dislocations
- Follow-up examination at 1, 4 and 8 weeks — neurovascular status and range of motion
- In recurrent dislocations, labrum/ligament evaluation (MRI) and surgical planning if needed
Risks
- Nerve injury (axillary at shoulder, ulnar/median at elbow; mostly transient)
- Vascular injury (rare but serious — especially in elbow and knee dislocations)
- Displacement of the fracture or new fracture formation (during difficult reduction)
- Recurrent dislocation (especially in young patients with shoulder dislocation, recurrence risk above 50%)
- Joint stiffness, capsule-ligament laxity or development of arthritis (long-term)
FAQ
Should I try to relocate the dislocation myself?
No. Improper manipulation can cause fracture, nerve or vascular injury. You must go to the emergency department; a fracture must be ruled out by X-ray before reduction.
Will my shoulder dislocation recur?
In young (under 20) and active individuals, the recurrence rate after a first dislocation can be as high as 50-90%. Risk decreases with age. In recurrent cases, surgical options such as labrum repair (Bankart) are evaluated.
Is the pain severe during reduction?
Pain is largely controlled with sedation or intra-articular anesthesia. With atraumatic techniques (Cunningham, Spaso), discomfort is kept minimal even when the patient is awake.
How long should I wear a sling after dislocation?
It varies by joint and age. For a young patient, the shoulder requires 1-3 weeks; in older patients, early mobilization is initiated. A short-term splint (1-2 weeks) for the elbow; for fingers, buddy taping with early movement is recommended.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Total Hip Replacement
Orthopedics & Traumatology
Total hip replacement — joint replacement surgery in which the hip is reconstructed with an artificial ball and socket.
PRP Injection
Orthopedics & Traumatology
PRP injection — application of platelet-rich plasma in selected tendon and joint conditions.
Intra-articular injection
Orthopedics & Traumatology
Intra-articular injection — pain management for osteoarthritis using hyaluronic acid and other medications.
PARTIAL HIP REPLACEMENT
Orthopedics & Traumatology
Partial hip replacement (hemiarthroplasty) — surgery to replace the femoral head for femoral neck fracture in elderly patients.
Entrapment Neuropathy Surgery
Orthopedics & Traumatology
Entrapment neuropathy surgery — decompression and release of peripheral nerves at sites of compression.
Shoulder Rotator Cuff Repair
Orthopedics & Traumatology
Shoulder rotator cuff repair — arthroscopic or open repair of torn supraspinatus and other rotator cuff tendons.
Tendon repair
Orthopedics & Traumatology
Tendon repair — end-to-end suturing of torn or ruptured tendons using open or percutaneous technique.
Cast and splint application
Orthopedics & Traumatology
Cast and splint application — external fixation of joints and bones for fractures, sprains, and post-surgical care.