I would recommend routinely getting pre- and post-reduction x-rays,
particularly for first dislocations. The pre- is necessary to confirm the
precise diagnosis, distinguish anterior from posterior dislocation in those
cases where it's not clear, and establish the presence of associated
fractures. The post- is required to establish reduction and confirm
displacement of any associated fractures. Besides, it's often difficult to
get the patient to describe a full range of movement immediately
post-reduction, with many joints remaining quite irritable and/or unstable
for several days to weeks post-reduction. Finally, axial views can be
difficult in many patients for similar reasons, and the transthoracic "Y"
view is safer and just as useful.
For recurrent dislocations you might be able to dispense with pre-or
post-reduction views or both as dictated by clinical judgement and common
----- Original Message -----
From: "Paul Bailey" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, January 20, 2006 1:03 PM
Subject: Re: Post reduction x-rays for anterior shoulder dislocation
>I think mostly the post reduction x-rays are performed to assess for
> complications of the reduction and the original injury eg #'s.
> There is no need for x-ray to confirm that the joint is actually
> relocated -
> you just ask the patient when they wake up (or if you haven't sedated them
> ask them any time!). If it's not painful and you can move it, chances are
> it's in the right place.
> Interestingly, last year I saw for the first time an unstable posterior
> shoulder dislocation that was easily reduced, but fell out again except
> we held it in external rotation.
> How many of you routinely get pre-reduction x-rays?
> Paul Bailey
> Western Australia
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of
> [log in to unmask]
> Sent: Friday, 20 January 2006 8:28 PM
> To: [log in to unmask]
> Subject: Post reduction x-rays for anterior shoulder dislocation
> Dear All,
> How many views do you all perform post reduction of a Anterior inferior
> dislocation of a shoulder.
> Do you all perform two views AP & an axial or Y view to make sure the
> shoulder has been properly reduced?
> Certainly it is good science but can be difficult to perform soon after
> I would appreciate your views
> Salim Shubber