Anterior fracture-dislocations of the shoulder: pitfalls in treatment

Fracture-dislocations of the shoulder can present difficulties in treatment. Two cases are described to illustrate the complications that can occur when an inexperienced examiner attempts a closed reduction of a two-part anterior fracture-dislocation of the shoulder. Careful clinical and radiologic evaluation (A-P and transcapular or axillary lateral X-rays) followed by appropriate management can help to prevent these problems from occurring. If there is evidence that the fracture is displaced by manipulation, immediate open reduction and internal fixation are recommended.