Dislocations Flashcards
what is the mechanism of shoulder dislocation?
Fall
Traction
Injury
what is the most common shoulder dislocation?
Anterior
Caused by fall with shoulder in external rotation,
Axillary nerve can be damaged = regimental badge area sensory assessment
Signsand causes of a posterior shoulder dislocation?
Cause: seizures
Light bulb sign,
Can also occur in fall with shoulder in internal rotation, humeral head displaces posterior to the glenoid
what is an inferior shoulder dislocation?
RARE,
arm held in abduction,
humeral head displaced inferior to the glenoid,
needs prompt neurovascular assessment and reduction
what is an associated injury with many shoulder dislocations?
labral tears etc.
management of shoulder dislocation?
closed reduction
- open reduction
- stabilisation and rehabilitation
what is the mechanism of elbow dislocation?
Tends to occur in children (holding parents hand - pulled elbow),
adults - sporting activities etc.)
what damage can be caused by an elbow dislocation?
Small risk of radial head and coronoid process fractures
Elbow usually pretty stable due to ligaments and stabilisers
Ante cubital fossa: neurovascular structures
how is an elbow dislocation managed?
closed reduction under sedation,
- 2 weeks in sling and rehabilitation
- Reduction methods: traction in extension +/- pressure over olecranon Recurrent instability risk is low!
what is the mechanism of an interphalangeal joint dislocation?
Hyperextension injury, direct axial blow
- like a football hitting the finger
how is an interphalangeal joint dislocation managed?
-Closed reduction under digital/metacarpal block (ring block) -
-2 weeks in neighbour strapping,
-volar slab in Edinburgh position if unstable
what is the first thing to do with a patella fracture?
CONFIRM whether it’s a patella dislocation OR knee dislocation -
very different (has different mechanisms
what is the mechanism of patella dislocation?
sudden quads contraction with a flexing knee
who gets a patella dislocation?
-Teenagers (and more common in girls)
Associations/causes: -
-hyper-mobility,
- genu valgum,
- increased femoral neck anteversion),
- lateral quads insertions
- weak vastus medialis
what else can be injured in a patella dislocation?
Can have torn MPFL (medial patella femoral ligament)
always lateral dislocation and often self-relocating
how is patella dislocation managed?
reduce with knee extension,
radiographs,
aspiration,
brace,
physiotherapy
if repeat dislocations surgery: lateral release/medial reefing, patella tendon realignment
what is the mechanism of knee dislocation?
High energy injuries,
what are the possible injuries which can accompany knee dislocation?
Vascular injuries: popliteal artery/vein injury, may not be obvious (intimal tear/thrombus)
Nerve injuries: peroneal nerve
how is a knee dislocation diagnosed?
plain radiographs,
there are associated fractures,
MRI
What surgery is done for a knee dislocation?
Early - vascular repair (6hr window),
nerve repair
Definitive - sequential ligamentous repair
Complications: arthrofibrosis and stiffness, ligamentous laxity, nerve/arterial injury
what is the mechanism of injury for a hip dislocation?
RTA dashboard injury,
-Fall from height etc
how does a hip dislocation present?
flexed, internally rotated, and adducted knee
what are the complications of hip dislocations?
sciatic nerve palsy, AVN of the femoral head, secondary OA of hip
what way does the hip dislocate?
Dislocated posteriorly Associated with posterior acetabular wall and femoral fractures
