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MSK Week 6 2017/18 > 6: Common dislocations > Flashcards

6: Common dislocations Flashcards

1
Q

Most fractures are reduced by which means?

A

Closed reduction

skin is CLOSED e.g by manipulation

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2
Q

If soft tissues are in the way of a dislocation, how are they reduced?

A

Open reduction

i.e surgically

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3
Q

What can be compromised by a joint dislocation?

A

Neurovasculature

nerves, arteries, veins

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4
Q

The vast majority of shoulder dislocations are (anterior / posterior).

Why?

A

anterior

bony, muscular shield posteriorly

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5
Q

What is an atraumatic cause of shoulder dislocation?

In which genetic conditions can it be seen?

A

Hypermobility (i.e ligamentous laxity)

Marfan’s syndrome, Ehlers-Danlos syndrome

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6
Q

Which movement can produce an anterior shoulder dislocation?

A

Extreme external rotation

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7
Q

Why can falling onto the elbow produce an anterior shoulder dislocation?

A

Superior translation of shoulder causes it to dislocate anteriorly

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8
Q

Which nerve may be compromised by an anterior shoulder dislocation?

A

Axillary nerve

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9
Q

What is a sign of axillary nerve injury following an anterior shoulder dislocation?

A

Loss of sensation in regimental badge patch area

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10
Q

What structures other than the axillary nerve may be injured by an anterior shoulder dislocation?

A

Axillary artery

Brachial plexus

Glenoid labrum

Posterior head of humerus

Rotator cuff muscles

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11
Q

What are the names for lesions associated with the

a) glenoid labrum
b) posterior head of the humerus

in anterior shoulder dislocations?

A

a) Bankart lesion

b) Hill-Sachs lesion

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12
Q

How are shoulder dislocations usually reduced?

A

Manually

i.e a closed fixation

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13
Q

The chances of recurrent shoulder dislocation (increases / decreases) with age.

A

decreases with age

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14
Q

What is the management of most shoulder dislocations?

A

Reduce

Fix (closed fixation e.g immobilisation with a sling)

Physiotherapy

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15
Q

How may rotator cuff tears be treated if they are causing impingement syndrome?

A

Subacromial decompression

Rotator cuff repair

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16
Q

What specific nerve injury is usually associated with axillary nerve compression in shoulder dislocations?

A

Neurapraxia

resolves within a month

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17
Q

What is the nerve injury one step up from neurapraxia which may occur in shoulder dislocation and may not resolve?

A

Axonotmesis

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18
Q

Which nerve supplies the deltoid muscles?

A

Axillary nerve

so compression may cause weakness

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19
Q

Posterior shoulder dislocations occur when a posterior force is exerted on an (abducted / adducted), (internally / externally) rotated shoulder.

A

adducted, internally rotated shoulder

20
Q

What X-ray sign is associated with posterior shoulder dislocations?

A

Light bulb sign

21
Q

What other joints of the shoulder girdle can dislocate?

A

Acromioclavicular joint

Sternoclavicular joint

22
Q

What ligaments may be disrupted by an AC joint dislocation?

A

Coracoclavicular ligaments

23
Q

What is the usual mechanism of AC joint dislocation?

A

Fall onto shoulder

24
Q

In which directions can the sternoclavicular joints dislocate?

A

Anteriorly

Posteriorly

25
Q

What structures can be compressed if the sternoclavicular joint dislocates posteriorly?

A

Trachea

Oesophagus

Brachiocephalic vein

26
Q

What symptoms may patients with a posterior SC joint dislocation present with?

A

Pain

Dyspnoea

Dysphagia

Venous congestion (swelling)

27
Q

Pure elbow dislocations have a ___ prognosis.

A

good

28
Q

What is a Monteggia fracutre?

A

Fractured ulna with a dislocated radial head @ elbow joint

29
Q

What is a Galeazzi fracture?

A

Fractured radius with a dislocated ulna @ DRU joint

30
Q

What carpal dislocation is commonly missed on imaging and must be treated quickly?

A

Perilunate dislocation

31
Q

What finger joint can dislocate and cause deformity?

A

PIP joint

32
Q

Describe

a) Swan neck
b) Boutonniere’s deformities?

A

a) Swan neck - DIP flexion, PIP hyperextension

b) Boutonniere’s - DIP hyperextension, PIP flexion

33
Q

What aspect of the pelvis can fracture in a hip dislocation?

A

Posterior wall of the acetabulum

34
Q

What is the big risk of hip dislocation?

A

AVN of femoral head

35
Q

Which nerve can be damaged by hip dislocation?

A

Sciatic nerve

36
Q

The hip joint usually dislocates (anteriorly / posteriorly).

A

posteriorly

37
Q

What joint arthroplasty is known to dislocate?

A

THRs

38
Q

How are hip dislocations treated?

A

Reduced

Fixed

Physio for early mobility

39
Q

What is a common knee dislocation in adolescents?

A

Patellar dislocation

40
Q

In which direction does the patella usually dislocate?

A

Laterally

41
Q

If a bone breaks during a knee/patellar dislocation, what will occur?

A

Lipohaemarthrosis

bloody fluid in the knee causing effusion and severe pain

42
Q

Patellar dislocations commonly ___.

A

recur

43
Q

What can be compromised in a full blown knee dislocation?

A

Popliteal artery

Common fibular nerve

Virtually all of the ligaments

44
Q

What complication, caused by swelling, may occur following a knee dislocation?

A

Compartment syndrome

45
Q

How are knee dislocations treated?

A

Reduce

Fix

+/- revascularisation, ligament reconstruction

46
Q

Which tarsal bone is at high risk of AVN?

A

Talus

47
Q

What is a fracture-dislocation of the TMT joint called?

A

Lisfranc fracture-dislocation

MSK Week 6 2017/18 (6 decks)

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