Ann R Coll Surg Engl 2009; 91: 2-7 2The glenohumeral joint of the shoulder is the most commonly dislocated joint in the human body. Acute dislocation is a surgical emergency and demands urgent relocation. Failure to reduce a dislocated shoulder successfully within the first 24 hours carries the risk that it will be impossible to achieve a stable closed reduction. 1Broadly speaking, anterior shoulder dislocation shows a bimodal age distribution (Fig. 1) Anterior dislocation of the shoulder is commonly seen in accident and emergency (A&E) and trauma clinics. In this article, we review the existing literature on the injury and the recent trends in management. MATERIALS AND METHODS We have discussed this condition with our colleagues and performed a Medline search ('anterior shoulder dislocation') of the relevant papers. We also describe key historical publications and recent developments regarding immobilisation of the joint. RESULTS Management decisions regarding this condition continue to vary between units, especially for recurrent and posterior dislocation. This paper lays some emphasis on the choice of analgesic agent when attempting shoulder reduction in the A&E setting. A summary of the data from our own department has provided a graphical representation of the classical age and sex distribution for this condition. CONCLUSIONS Shoulder dislocation is a common injury. Delays in diagnosis remain the single biggest obstacle to optimum results in this group of patients. A significant proportion will require eventual surgery and up to a third of these patients will go on to develop long-term shoulder arthritis. Even patients who have experienced a single episode of dislocation may go on to develop long-term sequelae.

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Ankle fractures are a common injury associated with trauma in the young patient and osteoporosis in the elderly patient. They can be associated with significant morbidity and challenging to manage. These patients are at an increased risk of developing post traumatic ankle arthritis as well as other complications. Therefore a systematic approach to the management of ankle fractures is required. We review the anatomy, clinical presentation and discuss the management options and potential complications commonly encountered in these injuries.