In an adult with an acute anterior shoulder dislocation and intact neurovascular status, which reduction maneuver is commonly used in the emergency department?

• A. Traction-countertraction
• B. Scapular manipulation
• C. Milch maneuver
• D. Cortisone injection

Answer: (B)

Scapular manipulation is commonly used in the ED for an acute anterior shoulder dislocation with intact neurovascular status because it provides a quick, effective reduction with less force and fewer analgesia requirements than older traction-based methods. By stabilizing the scapula and using gentle movements to realign the humeral head into the glenoid, many reductions occur without deep sedation. Traction-countertraction can be more painful and carries a higher risk of complications, the Milch maneuver is another technique but is not as consistently successful in the ED, and cortisone injection does not reduce the dislocation.