A stepped care approach to reduction of anterior shoulder dislocation in the prone position.

There are various methods of reducing anterior shoulder dislocations. The traditionally used methods like Kocher's and Hippocratic are associated with procedural complications and frequently require sedation/muscle relaxants which have their own complications and are associated with longer stay and monitoring requirement in the emergency department. We describe a stepped care approach to shoulder dislocation reduction in the prone position involving four steps and two new manipulation methods taking into consideration the pathological deforming forces in a dislocated shoulder and addressing them in a stepwise fashion. This method does not require sedation/muscle relaxants in the majority of cases, is easy to learn, relatively painless, associated with shorter stay in the emergency department and has fewer complications.