This is superior to 10 mg of IV morphine and 2 mg of midazolam. The patient is placed supine, with the arm abducted and the elbow flexed to 90 degrees. The examiner holds the elbow in position and guides the forearm of the patient outward, externally rotating the shoulder. No pressure is applied to the forearm to force external rotation. If necessary, the arm can be abducted while in external rotation.
Reduction usually occurs silently, unnoticed by the patient.
This method has the lowest rate of complications. Modified Stimson reduction. Analgesia or relaxation as noted above. Patient placed prone on a table with the injured shoulder hanging free. Further manipulation often required consisting of gentle internal and external rotation with downward traction.