Shoulder dislocation

Question 1

What is the most common type of shoulder dislocation?

Answer 1

AnteriorW

Question 2

What are posterior dislocations associated wit?

Answer 2

electric shocks and seizures

Question 3

What is a key complication of anterior dislocation? How does it present

Answer 3

Axillary nerve damage.
Loss of sensation in regimental badge area over the lateral deltoid
Motor weakness in deltoid and teres minor muscles

Question 4

What nerve roots are affected in axillary nerve damage?

Answer 4

c5 - c6

Question 5

What are Hills-Sachs lesions?

Answer 5

Compression fractures of the posterolateral part of head of the humerus

Question 6

What is the apprehension test?

Answer 6

Assesses for shoulder instability
The shoulder is abducted to 90 degrees, and the elbow is flexed to 90 degrees. The shoulder is then slowly externally rotated in this position while watching the patient. As the arm approaches 90 degrees of external rotation, patients with shoulder instability will become anxious and apprehensive, worried that the shoulder will dislocate. There is no pain associated with the movement, only apprehension.

Question 7

What are Bankart lesions?

Answer 7

Tears to the anterior portion of the labrum occurring with repeated subluxation/dislocation

Question 8

What are investigations

Answer 8

XR after reduction (not always needed before)
MRI to assess for damage and if planning for shoulder

Question 9

What is acute management

Answer 9

Gas and air
Broad arm sling
Closed reduction
Surgery if fracture
Post-reduction XRs
Immobilisation for a period after relocation of the shoulder

Question 10

What is involved in ongoing management ?

Answer 10

Physio
Shoulder stabilisation surgery - includes repairing Bankart lesions
Tightening the capsule
Bone graft
Correcting Hill-Sachs lesions