Inferior Shoulder Dislocation: A Report of Three Cases Reduced Using the 'Two-Step Manoeuvre'

Inferior shoulder dislocations are uncommon, accounting for a very small percentage of all shoulder dislocations. A reduction technique has been developed which involves a two-step process: the first involves converting the inferior dislocation into an anterior one and the second involves reducing the humeral head back into its anatomical position within the glenohumeral joint. Traditional methods, such as the overhead traction-counter traction technique, often require multiple attempts, the involvement of several medical professionals, and the use of significant sedation and analgesia, which can be more intensive for the patient. Inferior dislocations that are positioned beneath the coracoid process present a particular challenge. Although they might seem suitable for reduction using methods typically applied for anterior dislocations, their positioning is often too inferior for these techniques to be effective. This two-step reduction technique has been utilised successfully in sub-coracoid and sub-glenoid inferior shoulder dislocations. The method has proven advantageous as a single practitioner can perform it, usually requires only one attempt, involves minimal force, and can be done under conscious sedation. These benefits make it a valuable alternative to traditional approaches for reducing inferior shoulder dislocations.