Shoulder dislocation

Question 1

What are the 4 Rs of dislocation?

Answer 1

• Reduce
• Re-assess neurovascular status
• Repair
• Rehabilitate (Early immobilisation → Early mobilisation)

Question 2

What are the most common causes of shoulder dislocation?

Answer 2

Shoulder dislocations are most often caused by falls on an outstretched arm or traction injuries (pulling)

Question 3

What are the 3 main directions of shoulder dislocation?

Answer 3

• Anterior - Common
• Posterior
• Inferior - Rare

Question 4

How do anterior shoulder dislocations usually occur?

Answer 4

Anterior dislocation is usually caused by a fall with the shoulder in external rotation, causing the humeral head to move forward from the glenoid fossa

Question 5

How do posterior shoulder dislocations usually occur?

Answer 5

Posterior shoulder dislocation is usually caused by a fall with the shoulder in internal rotation, or by a direct blow to the anterior shoulder, forcing the humeral head backwards from the glenoid fossa

Question 6

How do inferior shoulder dislocations usually occur?

Answer 6

Inferior shoulder dislocation is caused by the arm being held in abduction

Question 7

Who is most likely to dislocated their shoulder?

Answer 7

Young adults

Question 8

What is shown on this X-ray?

Answer 8

Question 9

What is shown on this X-ray?

Answer 9

Question 10

What clinical investigations are required in shoulder dislocation?

Answer 10

X-ray
Sensory assessment of regimental badge region
Axillary nerve testing

Question 11

What are some methods of reduction in anterior dislocation?

Answer 11

Kocher method
Hippocratic method
Stimson method

Question 12

What is performed in the Kocher method of reducing anterior shoulder dislocation?

Answer 12

Relaxed lateral rotation followed by medial rotation

Question 13

What is performed in the Hippocratic method of reducing anterior shoulder dislocation?

Answer 13

Patient lies supine wile the arms are pulled towards the feet

Question 14

What is performed in the Stimson method of reducing anterior shoulder dislocation?

Answer 14

The patient lies prone with the arm hanging over the bed, where a weight is placed on the wrist

Question 15

What may be required in cases of late found dislocation of the shoulder?

Answer 15

In longer term dislocation that has not been picked up immediately, open reduction in surgery may be required