What is the typical mechanism for a posterior shoulder dislocation and the on-field response?

• A. Forced abduction and external rotation; immobilize in current position and transport; avoid reduction
• B. Direct anterior force; immediately reduce on-field
• C. Fall on an outstretched hand with mild pain; ice and immobilize at field
• D. Twisting injury with internal rotation; perform on-field reduction if possible

Answer: (A)

On-field management for a suspected posterior shoulder dislocation focuses on stabilizing the joint and getting the athlete to definitive care without attempting a reduction right there. Reducing a posterior dislocation in the field carries risks—nerve or blood vessel injury, additional fractures, or a failed reduction—so the safer approach is to immobilize the shoulder in the position found and arrange rapid transport to a facility where reduction can be performed under appropriate conditions with imaging and anesthesia if needed.

In terms of mechanism, posterior dislocations are typically driven posteriorly by forces such as seizures, electric shock, or direct posterior blows, whereas anterior dislocations more often result from forced abduction and external rotation. This context helps explain why the field response emphasizes immobilization and transport rather than on-field reduction.