Joint dislocations, Principles of Management

Question 1

Dislocation?

Answer 1

Complete joint disruption

Question 2

Subluxation?

Answer 2

Partial dislocation, not fully out of joint

Question 3

Diagnosis of a dislocation?

Answer 3

Involves both clinical and radiological diagnosis

->also look for any associated injuries e.g. fractures, neurovascular damage, soft tissue injuries

Question 4

What do you need to rule out before operating on a dislocation?

Answer 4

Any neurovascular damage, needs to be done before operating so that the operation itself cannot be blamed for any nerve damage

Question 5

Commonest type of shoulder dislocation?

Answer 5

Anterior dislocation

Question 6

Dislocation of shoulder which is often missed?

Answer 6

Posterior dislocation of shoulder

Question 7

What tends to cause posterior shoulder dislocation?

Answer 7

Electric shocks
Hyperglycaemic fits

Question 8

How will a patient with posterior shoulder dislocation present?

Answer 8

Pain in shoulder
Inability or pain when moving shoulder

Question 9

What will be seen on examination of a patient with a posterior shoulder dislocation?

Answer 9

Tenderness around shoulder
No deformity felt
Patient will be unable to externally rotate

->will not be able to externally rotate because the humeral head lies behind glenoid and will bang against it and not rotate. There will be normal external rotation on the unaffected side.

Question 10

Which nerve is at risk in ulnar disloccation?

Answer 10

Ulnar nerve

->radial and medial can also be affected

Question 11

When do hip dislocation tend to occur?

Answer 11

RTAs
Falls from height

Question 12

Which direction do ankles dislocate most commonly?

Answer 12

Laterally