Shoulder Dislocation and Instability

Question 1

95% of shoulder dislocations and/or instability occur in the _______ direction.

Answer 1

anterior

Question 2

What typically cause anterior dislocation and instability?

Answer 2

• blow to abducted externally rotated, and extended arm
• blow to posterior humerus
• fall on outstretched and abducted arm

Question 3

What to these patients typically complain of?

Answer 3

pain and feeling of instability when the arm is in the abducted and externally rotated position

Question 4

What can cause posterior dislocation?

Answer 4

• falls from a height
• violent muscle contraction due to epilepsy or shock
• blow to anterior shoulder

Question 5

What can cause inferior dislocation?

Answer 5

• axial loading with arm fully abducted or forceful hyperabduction of arm
• dislocation frequently occurs when patients fall and suddenly grasp on to an object overhead

Question 6

_____% of young, active individuals who had traumatic shoulder dislocation have labral injuries often described as Bankart lesions when the anterior inferior labrum is torn.

Answer 6

90%

Question 7

Who is more likely to have rotator cuff tears or fractures following dislocation

Answer 7

older patients (>55)

Question 8

What are atraumatic shoulder dislocations typically caused by?

Answer 8

intrinsic ligament laxity or repetitive microtrauma leading to joint instability (swimmers, gymnasts, pitchers)

Question 9

How does a patient hold a dislocated arm?

Answer 9

externally rotated (internally if posterior)

Question 10

What improves pain and deformity?

Answer 10

manual relocation

Question 11

What do patients with atraumatic shoulder injuries typically complain of?

Answer 11

sliding sensation during exercise or strenuous activity

Question 12

What are the typical radiographic views?

Answer 12

• AP
• Axillary lateral scapula (GH)
• Orthagonal (posterior)

Question 13

What is a Hill-Sachs deformity? How common are they? How are they viewed?

Answer 13

cortical depression in the humeral head made by the glenoid rim with dislocation
(35-40% of anterior dislocations)
AP radiograph with arm internally rotated

Question 14

What is a Bankart Lesion?

Answer 14

occur when glenoid labrum is disrupted with dislocation

Question 15

What are some procedures used to reduce acute dislocations??

Answer 15

• Stimson procedure

- traction countertraction procedure

Question 16

How long should a patient be immobilized in a sling?

Answer 16

2-4 weeks

Question 17

TUBS?

Answer 17

?

Question 18

AMBRI?

Answer 18

?