MSK, MVA, Trauma Flashcards
Define dislocation
Injury or disability caused when normal position of a joint or other part of the body is disturbed
What do most dislocations require prior to realigning?
Some degree of anesthesia/analgesia
Options for analgesia/anesthesia prior to reducing a dislocation
- Local anesthetic
- Nerve block
- Parenteral analgesics
- Conscious sedation
What makes a joint more difficult to relocate and why?
The longer a joint has been dislocated, more difficult to relocate due to muscle spasm
What should always be performed post-reduction of a dislocation?
X-ray and neurovascular check
MC dislocations of the mandible
Anterior and bilateral
Etiologies of mandible dislocation
- Trauma
- Yawning
- Hypermobility syndrome
Imaging for mandible dislocation
Panorex or mandible
Method of mandible reduction
- Conscious sedation for most
- Wrap thumbs with gauze
- Intraoral pressure down and back
FU care for mandible reduction
- Soft diet for 2 wks
- Oral surgery if nerve deficit present
How is a shoulder MC dislocated?
98% of time - humeral head displaced anterior to glenoid and inferior to coracoid
How does a shoulder dislocation MC present?
“Squared off” shoulder
Imaging finding of dislocated shoulder
Look for ball on tee
FU care of shoulder relocation
Immobilizer for 1-4 wks then PT
Methods of shoulder relocation
- Traction-countertraction
- Stimson
- Milch
- Kocher
- Scapular manipulation
MC type of elbow dislocation?
Posterior
What are elbow dislocations frequently associated with?
Fractures
Etiology of elbow dislocation
FOOSH
Methods of elbow relocation
- Sedation necessary
- Distal traction or interlocking hands
FU care of elbow relocation
- Splint in 90 degrees, sling
- ROM in 1-2 wks
What is a nursemaid’s elbow?
- Radial head subluxation
- Annular ligament displaces into radiocapitellar articulation
Who is MC affected by nursemaid’s elbow?
Girls, 6 mo-3 yo
Methods of nursemaid’s elbow relocation
- Hyperpronation w/elbow at 90 degrees
- Supination then flexion (less successful)
FU care of nursemaid’s elbow relocation
- Full use should return quickly
- Avoid pulling/twisting mechanisms
What is a Colles fracture?
Distal radius metaphysis fracture w/dorsal angulation
What presents as a “dinner fork” appearance?
Colles fracture