Open techniques are occasionally necessary for acute dislocations. Closed reduction with intravenous analgesia or sedation with general anesthesia should be attempted first for most uncomplicated dislocations. If general anesthesia is necessary, operating room personnel should prepare for the possibility of an open surgical procedure if closed reduction is unsuccessful. Excessive force should not be used in closed reduction because soft tissue or bone sometimes becomes interposed between the articular surfaces, making closed reduction impossible. Forceful manipulation under these conditions can result in fractures or additional articular trauma. The use of image intensification may aid in reduction and help prevent these complications.
