# Dislocation or subluxation - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Anterior Glenohumeral Joint Dislocation - StatPearls (NCBI Bookshelf NBK557862) - https://www.ncbi.nlm.nih.gov/books/NBK557862/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD48 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Anterior Glenohumeral Joint Dislocation - disease-level clinical article (dislocation-subluxation-clinical.txt) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text DISLOCATION OR SUBLUXATION Sources: Anterior Glenohumeral Joint Dislocation - StatPearls (NCBI Bookshelf NBK557862) - https://www.ncbi.nlm.nih.gov/books/NBK557862/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD48 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care, Anterior Glenohumeral Joint Dislocation - disease-level clinical article (dislocation-subluxation-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SIGNS - what you find (8) - The humeral head can be seen and felt sitting in an abnormally anterior position - Axillary nerve function is confirmed by sensation over the proximal outer arm and deltoid firing on abduction - Axillary artery integrity is confirmed by distal perfusion, intact pulses, and no expanding swelling or hematoma - Unlike an anterior dislocation, a posterior dislocation holds the arm internally rotated with reduced external rotation - An isolated lesser tuberosity fracture should raise suspicion for an underlying posterior dislocation - Inferior dislocation (luxatio erecta) leaves the arm fixed in a hyper-abducted position and carries a high rate of neurovascular injury - AC joint separation, which can be mistaken for a shoulder dislocation, accounts for 9% of shoulder girdle injuries - A proximal humerus fracture can show increased bruising suggesting soft-tissue or bone injury, sometimes with a fully displaced humeral head [bruising] TESTS (8) - Plain films with multiple views are required for the initial workup of any traumatic shoulder injury - An AP view shows cranial-caudal displacement, and an orthogonal view is needed to assess anteroposterior displacement - The Velpeau view, which needs no abduction and keeps the arm in a sling, is an alternative when the axillary view is too painful - The scapular Y view assesses humeral head position relative to the glenoid when other views are hard to interpret - Stryker notch views assess a Hill-Sachs lesion and Westpoint views assess bony glenoid loss - MR arthrogram evaluates labral pathology in younger patients, and MRI is considered in older patients for a concurrent rotator cuff tear - CT is useful in chronic dislocations to quantify humeral head or glenoid bone loss for treatment planning - A Zanca view, with the beam angled 30 degrees cranial, is added to standard clavicle films to assess the AC joint IF NOT THIS - what else fits (4) - Posterior dislocation, often from a seizure or electric shock, is frequently missed on initial presentation - Inferior dislocation (luxatio erecta) is the rarest type and results from high-energy trauma - AC joint separation can be mistaken for a glenohumeral dislocation and is graded by the six- type Rockwood system - A proximal humerus fracture can present similarly to or alongside a dislocation, sometimes needing urgent surgical referral Source StatPearls "Anterior Glenohumeral Joint Dislocation" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult Traumatic joint dislocation or subluxation of any site needs prompt reduction and imaging to exclude fracture or neurovascular injury; a GP can give analgesia and immobilise before referral. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Traumatic joint dislocation or subluxation of any site needs prompt reduction and imaging to exclude fracture or neurovascular injury; a GP can give analgesia and immobilise before referral. Caution Neurovascular compromise distal to the joint (pulseless, pale, numb limb), open dislocation, suspected spinal dislocation with cord signs. No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. RED FLAG - Delaying reduction over 24 hours increases the risk of neurovascular compromise, muscle spasm, and unstable reduction. RED FLAG - Proximal humerus fracture-dislocations with a displaced humeral head where closed reduction fails require emergent orthopedic surgical consultation for urgent open reduction. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)