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MSK > Dislocation > Flashcards

Dislocation Flashcards

1
Q

What is a dislocation

A

Complete separation of two articulating bone surfaces

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2
Q

What causes

A

Sudden impact

If recurrent can be due to low impact

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3
Q

What do you do if dislocated joint

A

Check neuromuscular status before and after reduction
2 view X-ray to confirm and look for fracture
X-ray after reduction

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4
Q

How is patient monitored if sedated

A 
Doctor + nurse
IV access as risk of reduced RR
Observation after
Go home with competent adult
No driving for 24 hours
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5
Q

What is important to give before reduction

A

Analgesia for pain and to relax muscles
Entonox = pain and muscle relaxant
Proprofol if more needed
Theatre if complex / co-morbid

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6
Q

What do you do if fracture present

A

Reduction often done in theatre under GA

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7
Q

What is most common type of glenohumeral dislocation

A

Anterior = 90%
Posterior in epilepsy
Superior = rare and usually follows major trauma

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8
Q

What are other types of shoulder dislocations

A

Acromioclavicular - clavicle loses all attachment with acromion
Sternovlacivular

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9
Q

When is acromioclavicular common

A

Collision
Fall on shoulder
FOOSH

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10
Q

What are signs of anterior dislocation

A 
Loss of shoulder contour
Dip where head used to be 
Bump where it is lying now
External rotation
Abduction
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11
Q

What is often associated

A

Greater tuberosity of humerus fracture
Bankart lesion - damage to glenoid labrum
Hill Sachs - cortical depression of humeral head

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12
Q

What is common sign in posterior dislocation

A

Light bulb sign
Head looks more rounded
Internal rotation and adduction

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13
Q

What is important to check in shoulder dislocation

A

Sensory in badge area
Deltoid function / contraction
Axillary nerve can be damaged most commonly
Any part of brachial plexus

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14
Q

What views and what do they show

A

AP
Y view
If anterior then moves anterior to Y
If posterior then moves posterior to Y

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15
Q

How do you Rx glenohumeral

A

Prompt reduction
Immobilisation for 3 weeks with collar and cuff
Physio to strength rotator cuff

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16
Q

What do you do for recurrent

A

Surgical repair of Bankart tear

17
Q

What do you do for different grades of acrmioclavicular

A 
1+2 = conservative with sling
3+5 = surgical
18
Q

What re complications of shoulder dislocation

A

Recurrent due to tear of labrum (Bankart)
Recurrent instability
Stiffness
Damage to axillary nerve (also in surgical neck of humerus fracture)
Damage to any part of brachial plexus

19
Q

What is most common elbow dislocation

A

Posterior of radial head

20
Q

What are articulations of elbow

A

Radial humeral
Ulnar humeral
Radial ulnar

21
Q

How do you Rx

A

Posterior splint with elbow flexed at 90 for 2 weeks

22
Q

What is associated

A

Radial head fracture

Ulnar and brachial artery injury

23
Q

What is most common hip dislocation

A

Posterior

24
Q

What is common if THR

A

Anterior

25
Q

What causes

A

Trauma
RTA
Fall from height

26
Q

What are signs of posterior dislocation

A

Short leg
Adducted
Internally rotated to accomodate

27
Q

What are signs of anterior dislocation

A

No shortening
Abducted
Externally rotated

28
Q

How do you Rx

A 
ABCDE
Analgesia
Reduction under GA within 6 hours to reduce AVN
Physio
Crutches till pain free
29
Q

What are risks of dislocation

A 
AVN
Sciatic injury if posterior
Femoral injury if anterior
OA
Recurrent
30
Q

What causes patella dislocation

A

Trauma
Direct blow to knee
Severe contraction of quads with knees stretched

31
Q

What is associated

A

Osteochondral fracture

32
Q

What are RF

A

High riding patella
Tibial torsion
Knock knee

33
Q

How do you Rx

A

May not detect on X-ray
Quick reduction
Splint and crutches

34
Q

How do you avoid wating

A

Straight leg raise whilst in splint

35
Q

What joint can ankle dislocate at

A

Talocalcaneal

Taloavicular

36
Q

What are signs of lateral dislocation

A

External rotation

Prominent medial malleolus

37
Q

How do you Rx

A

Urgent reduction
Sedaiton
Back slab for temporary immobilisation

38
Q

What is often required

A

Fixation in theatre

39
Q

What are complications

A

Associated multiple fractures
Stressed skin
Neurovascular compromise

MSK (21 decks)

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