Shoulder Dislocation

Question 1

Shoulder dislocation types

Answer 1

Ant .
Post .
Inferior

Question 2

Ant . Dislocation

Answer 2

Head of humerus dislocate ant . And lies ant . To glenoid cavity
Types
Preglenoid
Sub coracoid
Subclavicular

Question 3

AD
Mechanism

Answer 3

FOOSH with shouler abducted externally rotated

Question 4

Pathological changes of ad

Answer 4

1. Bankart lesion @BG -
   Avulsion of antero inferior glenoid labrum
   Sometimes associated with glenoid im fracture ( bony bankart lesion )
   2.Hill sachs lesion @H for humerus
   Depression of posterolateral aspect of humeral head
2. Rounding off of glenoid rim due to recurrent dislocation
3. There may be greater tuberosity # of humerus
4. Rotator cuff tear

Question 5

Bankart lesion

Answer 5

@BG

Question 6

Hill sachs lesion

Answer 6

@H for humerus

Question 7

Presenting complain

Answer 7

Pain
Restricted movement
Deformity - Shoulder abducted
Elbow supported with other hand
Bulge felt below clavicle
Flattening of lat. Outline of shoulder

Question 8

On examination

Answer 8

Fullness below clavicle
Normal shoulder contour lost
Arm abducted

Question 9

Tests performed

Answer 9

@BCD HR
Bryants test - Ant . Axillary fold lower level than opp. Side
Callaways test - vertical cicumference of axilla increased
Dugas test - unable to touch opp. Shoulder
Hamilton ruler test - ruler touched the acromion and lateral epicondyle
Regiment badge test - area of anesthesia around deltoid if axillary nerve injured

Question 10

Test for recurrent dislocation

Answer 10

Apprehension test
Drawer test
sulcus test
Relocation test

Question 11

Investigation

Answer 11

X ray
AP - overlapping shadows of humeral head and glenoid fossa
Axillary view
MRI OR MR Arthrography
Arthroscopy

Question 12

Treatment

Answer 12

Rule out axillary nerve injury ( regimen badge test ) and rotator cuff tear
Close reduction
Surgery :
Arthroscopic anterior stabilisation surgery

Question 13

Sx for RDS

Answer 13

Putti platt operation
Bankart operation
Bristow operation
Arthroscopic Bankart repair

Question 14

Close reduction

Answer 14

Kochers manoeuvre
Hippocrates method

Question 15

Kochers manoeuvre

Answer 15

@TEAI
TRACTION - longitudinal traction along tine of humerus with elbow flexed
EXTERNAL ROTATION OF ARM
ADDUCTION OF EXTERNALLY ROTATED ARM
INTERNAL ROTATION OF ARM so that hand touches the opposite shoulder

Question 16

Complications

Answer 16

Early
Rotator cuff tear
Axillary nerve and artery injury
#of acromian , coracoid greater tuberosity
Late
Shoulder stiffness
Unreduced dislocation
Osteoarthritis
RDS