An Improvised Reduction Method for Anterior Shoulder Dislocation in a Waterborne Environment

Anterior glenohumeral joint (shoulder) dislocations are common orthopedic injuries that require timely recognition and effective reduction to prevent long-term complications. Traditional reduction techniques are typically performed on land where inherent mechanical advantage is present. This case study explores a novel in-water, prehospital technique used to reduce a shoulder dislocation during a high surf event in San Diego, California. The case involves a 36-year-old male who sustained an anterior shoulder dislocation while surfing. After initial reduction attempts using commonly described techniques were unsuccessful due to an inability to achieve adequate leverage while afloat, an improvised reduction technique was implemented, which successfully reduced the joint while floating on the ocean surface. The novel maneuver and subsequent clinical course are outlined in this case report. This technique has applications in neutral buoyancy or low-gravity environments in which the typical reduction maneuvers that require gravity or friction as leverage may not be feasible.