Current concepts in shoulder and elbow fractures and dislocations

Shoulder and elbow fractures and dislocations are common injuries. The aim of this review is to provide an overview of the acute management of upper limb injuries, specifically, shoulder and elbow fractures and dislocations. The management of primary traumatic anterior shoulder dislocations is traditionally conservative however surgical management options should be discussed for patients considered at risk of recurrent instability. Early operative intervention has been shown to improve functional outcome for younger patients however further clinical trials are required to assess the role of surgery in older patients. The management of proximal humerus fractures remains contentious with current evidence advocating non-operative management with a potential role for reverse shoulder arthroplasty in complex fractures. Current management of simple elbow dislocations remains short-term immobilization which provides effective pain reduction but should be superseded by functional therapy after 1 week. The role of surgical management of simple elbow dislocations remains poorly investigated. Complex elbow dislocations frequently require operative intervention due to the loss of joint stability that results from injury. There are considerable areas of further research which should be carried out to improve understanding and effectiveness of current treatment.