Shoulder Dislocation Flashcards
Why are shoulder dislocations common
It is a highly mobile joint therefore stability is compromised for an increased range of movement => increased chance of dislocation
What can shoulder dislocations lead to if not managed properly
Chronic joint instability and chronic pain
What is the most common type of shoulder dislocation
Anteroinferior - aka anterior
Occurs 95% of the time
What causes a anterior dislocation of the shoulder
Force being applied to a extended, abducted and externally rotated humerus
What causes posterior dislocations
Seizures
Electrocution
Trauma ( arm is usually flexed, adducted)
Which dislocations are often missed
Posterior as they are harder to see on X ray
What are the important ligaments of the shoulder
Refer to teach me surgery
What are the clinical features of someone with a shoulder dislocation
Pain
Reduced movement
Instability
Examination: asymmetrical, loss of shoulder contours, anterior bulge
Important to assess neurovascular status
Shoulder dislocations have many commonly associated injuries, which can be divided into what two categories
Bony, labral and ligamentous
What are some associated bony injuries
Bony bankart lesions - fractures of the anterior and inferior glenoid bones - present in those with recurrent dislocations
Hill-Sachs defects - impaction injury to Chondral surface of posterior and superior part of the numeral head
Fractures of the greater tuberosity and surgical neck of humerus
What are some associated labral, ligamentous and rotator cuff injuries
Soft bankart lesions
Glenohumeral ligament avulsion
Rotator cuff injuries
what are the investigations for shoulder dislocation
Plain radiographs
A trauma series is required
What is a trauma shoulder series of X rays
AP
Y-scapular and axial views
Which x ray view is good at differentiating anterior and posterior shoulder dislocations
Y scapular view
Which x ray view is good for anterior dislocations
AP - can see the numeral head out of the Glenoid fossa
What is the sign thats seen on the x ray for posterior dislocation
Light bulb sign
If you suspect labral/rotator cuff injury, which imaging modality could you use.
MRI shoulder
What is the management of shoulder dislocations
A-E trauma assessment
Analgesia
Closed reduction - hippocratic Method ( only be done by a trained specialist)
Assess neurovascular status - pre and post reduction
Broad arm sling after reduction - immobilisation
Physiotherapy
Surgery may be required if any complications
What are the complications of those with shoulder dislocation
Chronic pain
Limited mobility
Stiffness
Recurrence
Adhesive capsulitis
Nerve damage
Rotator cuff injuries
Degenerative joint disease
