Outcomes of immediate reduction versus delayed management in shoulder dislocation

Naif S. Alaffari; Othman M. Mahzary; Ahmed A. Fallatah; Warif H. Farrash; Ahmed S. Aeq; Shaima M. Alkhayat; Ali M. Alnasser; Odai H. Taher; Abdulhadi A. R. Badawi; Sarra B. Elsadig; Ahmed A. Alzahrani

doi:10.18203/2394-6040.ijcmph20260120

Authors

Naif S. Alaffari Department of Orthopedics, King Fahad General Hospital, Jeddah, Saudi Arabia
Othman M. Mahzary College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
Ahmed A. Fallatah College of Medicine, Taibah University, Madinah, Saudi Arabia
Warif H. Farrash Collage of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
Ahmed S. Aeq College of Medicine, Taibah University, Madinah, Saudi Arabia
Shaima M. Alkhayat Collage of Medicine, Alexandria University, Alexandria, Egypt
Ali M. Alnasser Department of Internal Medicine, Qatif Centeral Hospital, Qatif, Saudi Arabia
Odai H. Taher College of Medicine, Taibah University, Madinah, Saudi Arabia
Abdulhadi A. R. Badawi College of Medicine, Taibah University, Madinah, Saudi Arabia
Sarra B. Elsadig Department of Emergency Medicine, Obied Specialized Hospital, Riyadh, Saudi Arabia
Ahmed A. Alzahrani Department of Orthopedic Surgery, Rabigh General Hospital, Jeddah, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20260120

Keywords:

Shoulder dislocation, Reduction timing, Recurrent instability, Functional outcomes, Joint management

Abstract

Shoulder dislocations are among the most frequently encountered joint injuries in emergency and orthopedic care, with anterior dislocations accounting for the majority of cases. The timing of reduction following dislocation plays a critical role in influencing short-term outcomes, procedural success, and long-term joint stability. Early reduction is often associated with decreased pain, improved ease of reduction, and lower sedation requirements. Delayed reduction, particularly beyond several hours post-injury, may increase the likelihood of reduction failure, nerve injury, or the need for operative intervention. Studies have shown that recurrence rates are higher in younger patients, especially when treatment is delayed or conservative methods are used without close follow-up. Functional recovery, including return to sport or daily activity, is significantly affected by the management approach and timing of reduction. Structural injuries such as Bankart lesions, Hill-Sachs defects, and rotator cuff tears further complicate outcomes and are more common in delayed or recurrent cases. The presence of risk factors like hyperlaxity, previous subluxations, and improper immobilization also contribute to instability. Imaging strategies, early rehabilitation protocols, and patient education are essential to support recovery and prevent re-dislocation. Variability in emergency department protocols, clinician experience, and resource availability can influence treatment timing and outcomes. Understanding how early versus delayed intervention shapes both immediate and extended recovery allows for more effective decision-making in both acute and follow-up care.

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