Management of first time shoulder dislocation

Glenohumeral dislocation is a common emergency department presentation. It is most often a traumatic anterior dislocation and occurs most frequently in young, active male patients. Shoulder instability and further dislocations may occur following primary dislocation, and these are associated with shoulder joint pathology and loss of function. Younger patients are more likely to experience further instability events, while shoulder dislocation is more often a singular event in older patients. There is debate regarding whether first time dislocators should be managed surgically or conservatively. This article discusses the evidence in the literature and current guidelines for the management of first time shoulder dislocation, proposing surgical management for young active patients following a first-time dislocation, most often an arthroscopic labral repair.