5- common dislocations

Question 1

which type of shoulder dislocation most common?

Answer 1

anterior

Question 2

what is characteristic sign of posterior dislocation on xray?

Answer 2

light bulb

Question 3

what are 2 main ways to reduce shoulder dislocation?

Answer 3

1. hippocratic = foot in axilla then arm gently adducted (closer to midline)
2. in-line traction = assistant required, towel pulled in opposite direction of person pulling arm

Question 4

what is important test to remember for shoulder dislocation - nerve problem?

Answer 4

regimental patch

Question 5

what are 3 types of elbow dislocation?

Answer 5

anterior, posterior, lateral

also radial head dislocation = parent pulling kids arm (easy to reduce)

Question 6

what direction are interphalangeal joints almost always dislocated?

Answer 6

posterior

Question 7

what are 4 R’s of joint dislocation?

Answer 7

1. Reduce
2. re-assess neurovascular status
3. repair
4. rehabilitate

Question 8

whats typical presentation and direction of patella dislocation?

Answer 8

teen girls, when sudden quad contraction & flexed knee (when leg & thigh are moving different direction & knee gets direct blow at same time)

= always lateral dislocation, often self relocating
= will have medial pain from torn medial retinaculum & haemarthrosis (effusion)

Question 9

what are risk factors for patella dislocation?

Answer 9

• hypermobility
• under-developed femoral condyle
• genu valgum (increased Q angle)
• weak lateral quads insertion or weak vastus medius

Question 10

what is management of patella dislocation?

Answer 10

reduce with knee extension, aspirate (sometimes), brace, physio

• if repeat dislocations can do surgery where reconstruct ligaments & might not solve pain

Question 11

what is general presentation of knee dislocation?

Answer 11

traumatic, high energy, often teen girls again

= often also multi ligament injury

Question 12

what 2 injuries suggest knee dislocation even if knee relocated itself?

Answer 12

lateral collateral ligament injury and peroneal nerve injury

Question 13

what are 2 important structures that have to check function of before & after knee dislocation & treatment?

Answer 13

popliteal artery (CT angiogram) & peroneal nerve

Question 14

what is most common way for hip dislocation?

Answer 14

posterior dislocation by high energy road traffic accident with knee against dashboard

Question 15

what structure is important to be assessed in hip dislocation? (at risk of trauma)

Answer 15

sciatic nerve

Question 16

what are complications of hip dislocation?

Answer 16

1. sciatic nerve palsy
2. avascular necrosis of femoral head
3. secondary osteoarthritis of hip

Question 17

what is management of hip dislocation?

Answer 17

hip back in joint and fix associated pelvic fractures