Reduction after shoulder dislocation | Physiotherapy after a shoulder dislocation

Reduction after shoulder dislocation

In the case of a shoulder dislocation, it is important to reduce the joint as quickly as possible. This is usually done conservatively. There are two main reduction procedures.

Reduction according to Arlt and Hippocrates. In Arlt reduction, the patient sits on a chair with the arm hanging down over the backrest. The backrest is used as a hypomochlion (lever).

The physician pulls the arm, and lifts the upper arm over the backrest back into the socket. According to Hippocrates, the patient lies on a couch and the doctor presses his foot against the patient near the armpit. The doctor’s foot in this case is the hypomochlion.

By pulling the arm, the head of the shoulder is brought back into the socket. Afterwards, a check is made to ensure that the reduction has been successful and that the arm is properly supplied with blood and innervated. If the arm cannot be successfully reduced conservatively, it may be necessary to surgically immobilize the joint. It is important to check motor function, sensitivity and blood flow in order to rule out concomitant injuries or entrapments with potentially serious consequences.

Immobilization/Duration after shoulder dislocation

After successful reduction, the shoulder joint is immobilized in a Gilchrist bandage. The arm is bent and rotated in front of the body. In the event of possible concomitant injuries such as the tearing of tendons or nerve damage, other positions may also be considered for immobilization (e.g. abduction cushions).

Young patients who want to put full weight on their arm again in everyday life and who are also active in sports may be immobilized for a longer period of time to reduce the risk of recurrence. Immobilization can be prescribed for 3-4 weeks and must be followed consistently. Afterwards the load is released bit by bit.

The rehabilitation is supported by intensive physiotherapy. In older patients who no longer place heavy and final demands on their arm in everyday life, a shorter immobilization may be sufficient to maintain mobility and independence in everyday life. Even after operations, immobilization is usually for a few weeks.