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Year 2 > Common dislocations > Flashcards

Common dislocations Flashcards

1
Q

What are the two most common dislocations?

A

Shoulder

Knee - patella

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2
Q

What might you expect to see on inspection of a dislocation?

A

Deformity

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3
Q

What should you palpate for before any intervention on a dislocation?

A

Blood and nerve supply

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4
Q

By which mechanisms do shoulder dislocations most commonly occur?

A

Fall
Traction
Seizure

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5
Q

In which directions can a shoulder dislocate?

A

Anterior
Posterior
Luxatio erecta (i.e inferior)

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6
Q

Who most commonly presents with a shoulder dislocation?

A

Young adults

Elderly with weakened soft tissues

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7
Q

What is the most common direction for a shoulder to dislocate?

A

Anterior

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8
Q

By which mechanism does an anterior shoulder dislocation occur?

A

Fall backwards (shoulder externally rotated)

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9
Q

How must an anterior shoulder dislocation be assessed?

A

Badge area sensory assessment to rule out compression of the axillary nerve

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10
Q

By which mechanisms does a posterior shoulder dislocation occur?

A

Fall (shoulder internally rotated)

Direct blow to anterior shoulder

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11
Q

How does a patient with an inferior shoulder dislocation hold their arm?

A

In abduction

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12
Q

How must an inferior shoulder dislocation be assessed?

A

Prompt neurovascular assessment and reduction

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13
Q

What is the radiological sign indicating a posterior shoulder dislocation?

A

Light bulb sign

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14
Q

How is a shoulder dislocation managed?

A

Closed reduction under anaesthetic
Stabilisation
Rehabilitation

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15
Q

When might a shoulder dislocation be managed with an open reduction?

A

Fixed posterior dislocations

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16
Q

What is the main predictor of recurrent instability with a shoulder dislocation?

A

Age - the older the patient is the less likely it is to recur

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17
Q

What are the three main techniques of shoulder reduction?

A

Hippocratic, kocher’s, in line traction

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18
Q

By which mechanism does an elbow dislocation occur?

A

Fall onto outstretched hand

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19
Q

Who gets elbow dislocations?

A

Adults

Children

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20
Q

In which directions can an elbow dislocate?

A

Anterior
Posterior
Medial
Lateral

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21
Q

What are the associated risks with an elbow dislocation?

A

Radial head fracture

Coronoid process fracture

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22
Q

By which mechanism does a radial head dislocation commonly occur?

A

Traction (pulling on the forearm)

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23
Q

Who gets radial head dislocation?

A

Children and infants

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24
Q

What is the risk for recurrent instability with an elbow dislocation?

A

Low

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25
Q

How is elbow dislocation managed?

A

Closed reduction under anaesthetic
2 weeks in a sling
Extensive rehabilitation

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26
Q

Why do elbow dislocations need to undergo rehabilitation?

A

They are prone to stiffness

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27
Q

How is an elbow dislocation reduced?

A

Traction in extension +/- pressure over olecranon

28
Q

By which mechanisms do interphalangeal joint dislocations occur?

A

Hyperextension

Direct axial blow

29
Q

In which direction does interphalangeal joint dislocation most commonly occur?

A

Posterior

30
Q

What are the associated injuries of a dislocated interphalageal joint?

A

Phalangeal herniation through volar plate

Associated fracture –> recurrent instability

31
Q

How are interphalangeal joint dislocations managed?

A

Closed reduction with digital/metacarpal block

2 weeks in neighbour strapping

32
Q

How is an interphalangeal joint dislocation managed if it’s unstabled?

A

Volar slab in edinburgh position

33
Q

How are interphalangeal joint dislocations reduced?

A

In line traction with corrective pressure

34
Q

What is the mechanism of patellar dislocation?

A

Sudden quadriceps contraction while the knee is bent

35
Q

What is the direction of patellar dislocation?

A

Lateral

36
Q

Who gets patellar dislocation?

A

Teenagers (girls)

37
Q

What are the associations with patellar dislocation?

A 
Hypermobility
Hypoplastic lateral femoral condyle
Increased Q-angle (genu valgum, femoral neck anteversion)
Lateral quads insertion
Weak vastus medialis
38
Q

What is typically found on examination on patellar dislocation?

A

Medial pain
Patellar apprehension test positive
Effusion

39
Q

What is the cause of the effusion in patellar dislocation?

A

Haemarthrosis

40
Q

What is the cause of medial pain in patellar dislocation?

A

Torn medial retinaculum

41
Q

How patellar dislocation managed?

A 
Reduction on extension
Radiograph
Aspirate
Brace
Physiotherapy
42
Q

How is repeat patellar dislocation managed?

A

Surgically - lateral release + medial reefing OR patellar tendon realignment

43
Q

Are knee dislocations high or low velocity?

A

Most often high velocity

44
Q

Can knee dislocations spontaneously relocate?

A

Yes

45
Q

Which injuries indicated a knee dislocation that has spontaneously relocated?

A

Lateral collateral ligament injury

Peroneal nerve injury

46
Q

Who typically gets knee dislocations?

A

Teenagers with ligamentous laxity (girls)

47
Q

What directions can the knee dislocate?

A 
Medial
Lateral
Rotatory 
Posterior
Anterior
48
Q

What is the most common direction the knee dislocates?

A

Posterior

49
Q

What are the common vascular injuries caused by a knee dislocation?

A

Popliteal artery
Vein injury
Intimal tear/thrombus

50
Q

What nerve gets injured with a knee dislocation?

A

Peroneal injury

51
Q

How is a knee dislocation monitored for complications?

A

Normal exam - monitor

Clinical concern - arteriogram or MRI

52
Q

How is ligamentous injury checked with knee dislocation?

A

Examination under anaesthetic

53
Q

How is a knee dislocation managed?

A

Reduction under anaesthetic

Stabilise in splint/external fixation

54
Q

When might surgical reduction be required for knee dislocation?

A

Condyle herniation through capsule

55
Q

What type of imaging is indicated for knee dislocations and why?

A

X-rays for associated fractures

MRI

56
Q

What type of early surgery is indicated for knee dislocations?

A

Vascular repair

Nerve repair

57
Q

What type of definitive surgery is indicated for knee dislocations?

A

Sequential ligamentous repair

58
Q

What are the possible complications of knee dislocation?

A

Post-traumatic arthritis and stiffness
Nerve/artery injury
Ligamentous laxity

59
Q

What is the common mechanisms of hip dislocation?

A

RTA - dashboard injury
Fall from height
(High velocity)

60
Q

What is the most common direction of hip dislocation?

A

Posterior

61
Q

What are the fractures associated with hip dislocation?

A

Posterior acetabular wall

Femoral

62
Q

How does a dislocated hip present?

A

Flexed
Internally rotated
Adducted knee

63
Q

How is a hip dislocation managed?

A 
Neurovascular assessment
X-ray
Urgent reduction
Possible stabilisation in-traction
Imaging/CT
64
Q

What nerve is at risk in hip dislocation?

A

Sciatic

65
Q

What are the complications of hip dislocation?

A

Sciatic nerve palsy
Avascular necrosis
Secondary osteoarthritis of the hip
Myositis ossificans

Year 2 (72 decks)

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