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MSK Cortext > Common Dislocations > Flashcards

Common Dislocations Flashcards

1
Q

what is the most common cause of dislocation?

A

trauma

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2
Q

where can the shoulder dislocate?

A

anterior - most common
posterior
inferior - rare

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3
Q

who is shoulder dislocation most common in?

A

young adults - esp females

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4
Q

what is an anterior shoulder dislocation and what causes it?

A

humeral head is anterior to the glenoid

caused by fall with shoulder in external rotation

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5
Q

how do you assess axillary nerve?

A

assess sensation in regimental badge area

- often damaged in anterior shoulder dislocation

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6
Q

what is a posterior shoulder dislocation and what causes it?

A

humeral head posterior to glenoid

caused by fall with shoulder in internal rotation or direct blow to anterior shoulder

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7
Q

X ray sign of posterior shoulder dislocation?

A

light bulb sign

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8
Q

what is an inferior shoulder dislocation and what causes it?

A

humeral head inferior to glenoid

arm held in abduction

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9
Q

what must be done if inferior dislocation of shoulder?

A

NV assessment and reduction

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10
Q

how is shoulder dislocation managed?

A

closed reduction under sedation
open reduction
stabilisation and rehabilitation

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11
Q

possible reduction methods?

A

hippocratic

in line traction

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12
Q

what affects instability of shoulder after dislocation?

A

age at time of dislocation

- younger = higher risk of instability

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13
Q

what usually causes elbow dislocation?

A

fall onto outstretched hand

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14
Q

how can an elbow dislocate and who does this usually occur in?

A 
posterior
anterior
medial
lateral
occurs in adults and children
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15
Q

risks with elbow dislocation?

A

radial head or coronoid process fracture

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16
Q

what moves in elbow dislocations?

A

ulna/radius

- humerus stays the same

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17
Q

what is a pulled elbow?

A

radial head dislocation/possible elbow dislocation due to arm being pulled upwards

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18
Q

how do you manage elbow dislocation?

A

closed reduction under sedation
open reduction is rare
2 weeks in sling and rehab

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19
Q

reduction methods in elbow?

A

traction in extension +/- pressure over olecranon

20
Q

common mechanism of interphalangeal joints dislocations?

A

hyperextension injury
direct axial blow
- almost always dislocates posteriorly

21
Q

possible pitfalls in IP joint dislocation?

A

head of phalanx button-holes through volar plate

recurrent instability due to associated fracture

22
Q

how can you assess neurovasculature in the hand/fingers?

A

cap refill - compare to unaffected finger

assess sensation

23
Q

how is IP joint dislocation managed?

A

closed reduction under digital or metacarpal block
open reduction = rare
2 weeks neighbour strapping
volar slab in edinburgh position if unstable

24
Q

reduction methods for IP joints?

A

in line traction + corrective pressure

25
Q

where is anaesthesia applied for finger reduction?

A

in web space

gives specific numbness only in the finger

26
Q

what is the edinburgh position?

A

position of safety

prevents contracture of tendons

27
Q

what commonly causes patella dislocation and how does it dislocate usually?

A

sudden quads contraction with a flexing knee
almost always lateral
in teenage girls

28
Q

what is patella dislocation associated with?

A

hypermobility
under-developed lateral femoral condyle
increased Q angle (valgus, femoral neck anteversion)
lateral quads insertions or weak vastus medialis

29
Q

how do you assess Q angle?

A

line 1 = from ASIS to middle of patella
line 2 = tibial tubercle to middle of patella
angle between lines = Q angle

30
Q

problems in which structure can predispose to lateral patella dislocation?

A

medial retinaculum

31
Q

how does patella dislocation present?

A 
can have medial knee pain
clear lateral dislocation
often self relocating
effusion (haemarthrosis)
patella apprehension test +ve
32
Q

how is patella dislocation managed?

A 
reduce with knee extension
radiographs
aspiration
brace
physio
surgical if recurrent dislocation
- lateral release/medial reefing
- patella tendon realignment
- replace MPFL with graft
33
Q

what causes knee dislocation?

A

high velocity injuries

low velocity injuries - if knee goes back on itself after dislocation

34
Q

how can a spontaneously relocated knee dislocation injury diagnosed if normal X ray?

A

lateral collateral ligament injury + fibular nerve injury = dislocation

35
Q

how can the knee dislocate?

A

anterior
posterior
rotational, medial, lateral

36
Q

risk with posterior knee dislocation?

A

damage to popliteal artery

37
Q

how is a knee dislocation assessed?

A

popliteal artery/vein injury (may not be obvious - intimal tear or thrombus)
nerve injury - peroneal nerve
ligamentous stability - examination under anaesthetic
normal exam = observe in hospital
clinical concern = arteriogram/MRI

38
Q

urgent management of knee dislocation?

A 
reduction under sedation
- may need open reduction if condyle button-holed through capsule
stabilise in splint or external fixation
plain radiographs
MRI
39
Q

early knee dislocation surgery?

A 
vascular repair (6 hr window)
nerve repair
40
Q

definitive knee dislocation surgery? what are the risks with this?

A 
sequential ligamentous repair
complications
- arthrofibrosis and stiffness
- ligament laxity
- nerve or arterial injury
41
Q

what usually causes native hip dislocation? and which direction does it dislocate?

A

high velocity injury (RTA, fall from height etc)

- usually posterior

42
Q

what other injuries is hip dislocation associated with?

A

posterior acetabular wall or femoral fracture

43
Q

how does hip dislocation present?

A

hip flexed and internally rotated with knee adducted

44
Q

early management of hip dislocation?

A 
NV assessment (esp. sciatic nerve)
radiographs
urgent reduction
stabilise in traction if required
further imaging (CT)
45
Q

definitive management of hip dislocation? what are the risks?

A 
fixation of associated pelvic fractures
fixation of other injuries in poly-trauma 
complications
- sciatic nerve palsy
- avascular necrosis of femoral head
- secondary osteoarthritis of hip

MSK Cortext (61 decks)

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