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Closed reduction of glenohumeral dislocations with associated tuberosity fracture in the emergency department is safe

Injury Oct 01, 2020

Mackenzie SP, Hackney RJ, Crosbie G, et al. - In view of the association of a fracture of the tuberosity with 16% of glenohumeral dislocations and the the possibility of extension of the fracture into the humeral neck during closed manipulation, some have suggested managing all such injures under general anesthesia in the operating theatre. Researchers here reviewed data of 188 consecutive glenohumeral dislocations with associated tuberosity fractures obtained from a prospective orthopaedic trauma database with the aim to establish the safety of reduction of glenohumeral dislocations with tuberosity fractures in the emergency department (ED). Findings suggest that in the emergency department, experienced clinicians can safely attempt closed manipulation of glenohumeral dislocations with associated tuberosity fractures. Failure was reported in 11% of attempted reductions; subsequent reduction was performed on these in the operating theatre. They emphasize not making more than two attempts at reduction in the emergency department. During reduction, risk of iatrogenic humeral neck fracture of 1% was observed.

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