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MSK > Dislocations > Flashcards

Dislocations Flashcards

1
Q

what MUST be examined and documented

A

vascular supply and neurology

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2
Q

what are the directions a shoulder can dislocate

A

anterior (most common)
posterior
inferior (rare)

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3
Q

who most commonly gets shoulder dislocations

A

young adults- sports

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4
Q

what is the most common mechanism of injury for anterior shoulder

A

fall with shoulder in external rotation

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5
Q

what is the anatomical position of anterior shoulder dislocation

A

humeral head anterior to the glenoid

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6
Q

where do you asses in an anterior shoulder dislocation

A

regimental badge area sensory assessment

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7
Q

what nerve are you testing in the regimental badge area

A

axillary nerve

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8
Q

what is the common mechanisms for a posterior shoulder dislocation

A

fall with shoulder in internal rotation

direct blow to anterior shoulder

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9
Q

what is the anatomical position of posterior shoulder dislocation

A

humeral head posterior to the glenoid

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10
Q

what does a light bulb sign suggest

A

posterior dislocation

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11
Q

what is the anatomical position of inferior shoulder dislocation

A

humeral head inferior to the glenoid

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12
Q

what does an inferior dislocation need

A

prompt neurovascular assessment and reduction

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13
Q

how do you manage a shoulder dislocation

A

closed reduction under sedation
open reduction
stabilisation and rehabilitation

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14
Q

what are the shoulder reduction methods

A

hippocratic

inline traction

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15
Q

who is more likely to get recurrent instability after a shoulder dislocation

A

younger patients

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16
Q

how do you dislocate your elbow

A

fall onto outstretched hand

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17
Q

what directions can you dislocate your elbow

A

posterior, anterior, medial/lateral/divergent

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18
Q

what is there a small risk of in elbow dislocations

A

radial head #

coronoid process #

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19
Q

how do you manage an elbow dislocation

A

closed reduction under sedation
open reduction (rarely required)
2 weeks in sling and rehabilitation

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20
Q

what are the reduction methods for an elbow dislocation

A

traction in extension +/- pressure over olecranon

21
Q

what is the recurrent instability risk for elbow dislocation

A

low

22
Q

how do you dislocate your IPJs

A

hyperextension injury

direct axial blow

23
Q

what direction does the IPJs dislocate

A

almost always posterior

24
Q

what can go wrong in an IPJ dislocation

A

head of phalanx button holes through your volar plate

recurrent instability due to associated fracture

25
Q

how do you manage an IPJ dislocation

A

closed reduction under digital or metacarpal block
open reduction (rarely required)
2 weeks neighbour strapping
volar slab in edinburgh position if unstable

26
Q

what are the reduction methods for IPJs dislocation

A

in line traction + corrective pressure

27
Q

what is the purpose of the edinburgh position

A

prevents contracture of tendons

28
Q

how do you dislocate your patella

A

sudden quads contraction with a flexing knee

29
Q

what direction does a patella ‘always’ dislocate

A

lateral

30
Q

who gets patella dislocations

A

teenagers, girls > boys

31
Q

what is associated/ can cause patella dislocations

A

hypermobility

under-developed (hyperplastic) lateral femoral condyle

increased Q angle (genu valgum, increased femoral neck anteversion)

lateral quads insertions or weak vastus medialis

32
Q

what lines make up the q angle

A

line from ASIS to midpoint of patella

line from tibial tubercle to midpoint of patella

33
Q

what is seen on an exam in patella dislocation

A

pain medially (from torn medial retinaculum)
effusion (haemarthrosis)
patella apprehension test +ve

(often self relocating)

34
Q

how do you manage a patella dislocation

A 
reduce with knee extension
radiographs
aspiration 
brace 
physiotherapy
35
Q

how do you manage repeat patella dislocations

A

surgery: lateral release/ medial reefing

patella tendon realignment

36
Q

spontaneous knee relocations are common- what signs means the knee was definitely dislocated

A

lateral collateral lig injury + peroneal nerve injury = dislocationa

37
Q

what nerve and artery is damaged in knee dislocations

A

peroneal

popliteal artery

38
Q

what tests should be done for clinical suspicion of a vascular injury in knee dislocation

A

anteriogram/ MRI

check popliteal artery and vein

39
Q

what is the urgent management for a knee dislocation

A

reduction under anaesthetic
theatre reduction if condyle button hole through capsule
stabilise in splint or external- fixation

40
Q

what imaging for knee dislocation

A

plain radiographs- look for associated fractures

MRI

41
Q

what are the surgery options for knee dislocations

A

early: vascular repair (6hr window), nerve repair
definitive: sequential ligamentous repair

42
Q

what are the possible complications of knee dislocation sugery

A

Arthrofibrosis and stiffness
Ligament laxity
Nerve or arterial injury

43
Q

what direction does a hip usually dislocate

A

posterior

44
Q

what # are associated with a hip dislocation

A

posterior acetabular wall

femoral #

45
Q

what is the presentation of a dislocated hip

A

flexed, internally rotated and adducted knee

46
Q

what is the early management of a hip dislocation

A 
neurovascular assessment (sciatic nerve)
radiographs 
urgent reduction 
stabilise in traction if required 
further imaging (CT)
47
Q

what is the definitive management of a hip dislocation

A

fixation of associated pelvic fractures

fixation of other injuries in poly trauam

48
Q

what is the complications of a hip dislocation

A

sciatic nerve palsy
avascular necrosis of the femoral head
secondary osteoarthritis of hip

MSK (71 decks)

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