The dislocation needs to be reduced as soon as possible to preserve the viability of the humeral head and neurological integrity. Typically, reduction should be done open with muscle relaxing anesthesia. This procedure is usually combined with an osteosynthesis. If attempted as a closed reduction, remember that this may be unsuccessful with need for an open procedure. All treatment options carry the high risk of avascular necrosis.
Operative fixation is the preferred treatment. However, the decision for surgery should also include the functional demands of the patients, the presence of comorbidities, and the ability to undergo operative treatment.