Dislocations around the shoulder

The prevalence of traumatic dislocations of the shoulder in the elderly is increasing due to lifestyle changes and prolonged life expectancy. A dislocation of the shoulder is usually due to a low energy fall onto the outstretched hand in the elderly, unlike younger patients where it is commonly due to higher energy injuries, for example during sports. Patients can present with an acute dislocation in the emergency room or subacutely with a history of dislocation which has been reduced with persistent pain, weakness of the shoulder, neurological deficit, stiffness due to prolonged immobilization or recurrent dislocation. In a patient with an acute dislocation, detailed plain radio-graphs include a true anteroposterior, modified axial and scapular lateral views prior to reduction. Treatment of greater tuberosity fractures following a shoulder dislocation depends on patient specific and fracture specific factors. Associated injuries such as significant labral tears displaced greater tuberosity fractures and proximal humerus fractures should be addressed on an individual patient basis.