Shoulder dislocation

Question 1

4 types of anterior shoulder dislocations

Answer 1

1. subglenoid
2. subcoracoid
3. intrathoracic
4. subclavicular

Question 2

Most common nerve injury in anterior shoulder dislocation

Answer 2

axillary

Question 3

List and describe 2 fractures commonly seen in anterior shoulder dislocation

Answer 3

1. Bankart: depression of humeral head

2. Hill Sachs: labrum disruption

Question 4

List 6 ways to reduce a shoulder dislocation

Answer 4

1. scapular manipulation
2. Cunningham
3. traction/countertraction
4. external rotation
5. Stimson’s technique: pt prone with affected arm hanging down with progressive weights attached
6. Milch technique: Place affected arm in full abduction overhead, with arm in full abduction, gently apply longitudinal traction and external rotation with one arm.
7. FARES shoulder dislocaiton

Question 5

List 2 most common causes of posterior shoulder dislocation

Answer 5

1. electrocution
2. seizure
3. High speed MVC
   Direct blow to anterior shoulder
   FOOSH with arm adducted, flexed, internally rotated

Question 6

X ray findings to identify a posterior shoulder dislocation

Answer 6

1. Rim sign

2. Light bulb sign

Question 7

How long is the shoulder immobilized after reduction?

Answer 7

• Young LT 40: 3 – 6 weeks (more likely to recur)
  Old GT 40: 1 – 2 weeks (recur less, higher risk for stiffness in some studies, although has failed to be replicated consistently between RCTs)

Question 8

List steps in the management of a rotator cuff tear.

Answer 8

Acute tears:
- Sling immobilization
Referral to ortho for early surgical repair