Shoulder Dislocation Flashcards

1
Q

Why are shoulder dislocations common

A

It is a highly mobile joint therefore stability is compromised for an increased range of movement => increased chance of dislocation

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2
Q

What can shoulder dislocations lead to if not managed properly

A

Chronic joint instability and chronic pain

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3
Q

What is the most common type of shoulder dislocation

A

Anteroinferior - aka anterior

Occurs 95% of the time

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4
Q

What causes a anterior dislocation of the shoulder

A

Force being applied to a extended, abducted and externally rotated humerus

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5
Q

What causes posterior dislocations

A

Seizures

Electrocution

Trauma ( arm is usually flexed, adducted)

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6
Q

Which dislocations are often missed

A

Posterior as they are harder to see on X ray

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7
Q

What are the important ligaments of the shoulder

A

Refer to teach me surgery

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8
Q

What are the clinical features of someone with a shoulder dislocation

A

Pain

Reduced movement

Instability

Examination: asymmetrical, loss of shoulder contours, anterior bulge

Important to assess neurovascular status

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9
Q

Shoulder dislocations have many commonly associated injuries, which can be divided into what two categories

A

Bony, labral and ligamentous

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10
Q

What are some associated bony injuries

A

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

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11
Q

What are some associated labral, ligamentous and rotator cuff injuries

A

Soft bankart lesions

Glenohumeral ligament avulsion

Rotator cuff injuries

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12
Q

what are the investigations for shoulder dislocation

A

Plain radiographs

A trauma series is required

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13
Q

What is a trauma shoulder series of X rays

A

AP

Y-scapular and axial views

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14
Q

Which x ray view is good at differentiating anterior and posterior shoulder dislocations

A

Y scapular view

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15
Q

Which x ray view is good for anterior dislocations

A

AP - can see the numeral head out of the Glenoid fossa

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16
Q

What is the sign thats seen on the x ray for posterior dislocation

A

Light bulb sign

17
Q

If you suspect labral/rotator cuff injury, which imaging modality could you use.

A

MRI shoulder

18
Q

What is the management of shoulder dislocations

A

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

19
Q

What are the complications of those with shoulder dislocation

A

Chronic pain

Limited mobility

Stiffness

Recurrence

Adhesive capsulitis

Nerve damage

Rotator cuff injuries

Degenerative joint disease