Anterior Shoulder Dislocation

Question 1

Anterior is more common than posterior. True or False?

Answer 1

True

Question 2

What kind of fall can cause anterior shoulder dislocation?

Answer 2

Fall onto back of shoulder

-Excessive external rotation force

Question 3

Usual pathology for anterior shoulder dislocation?

Answer 3

Detachment of anterior glenoid labrum & capsule
AKA
Bankart lesion

Question 4

What is Hill-sachs lesion?

Answer 4

Posterior humeral head can impact on anterior glenoid

Impaction fracture of posterior head

Question 5

Occasional nerve/vessel complications of anterior dislocations?

Answer 5

Axillary nerve can be stretch

Nerves of brachial plexus & axillary artery can be stretched and compressed

Question 6

Signs and symptoms of anterior shoulder dislocation?

Answer 6

• Loss of symmetry & roundness of shoulder
• Arm held in adducted position by patient’s other arm
• Difficult to determine deltoid contraction in acute phase
• Difficult to assess rotator cuff tears
• Axillary nerve injury: loss of sensation in regimental badge area

Question 7

Investigation of anterior shoulder dislocation?

Answer 7

• Full distal neurovascular assessment

- X-ray: confirm injury (2 planes helpful)

Question 8

Treatment of anterior shoulder dislocation?

Answer 8

• Closed reduction under sedation/anaesthetic

- If delayed presentation it is is difficult to reduce so do open reduction

Question 9

How to treat if there is a greater tuberosity fracture?

Answer 9

• Usually okay with reduction of shoulder

- If remains displaced: ORIF

Question 10

How to treat surgical neck fracture?

Answer 10

Surgery

Question 11

How are recurrent dislocations treated?

Answer 11

Reattachment of labrum & capsule

-Arthroscopic/open