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Flashcards in Common dislocations Deck (65):
1

What are the two most common dislocations?

Shoulder
Knee - patella

2

What might you expect to see on inspection of a dislocation?

Deformity

3

What should you palpate for before any intervention on a dislocation?

Blood and nerve supply

4

By which mechanisms do shoulder dislocations most commonly occur?

Fall
Traction
Seizure

5

In which directions can a shoulder dislocate?

Anterior
Posterior
Luxatio erecta (i.e inferior)

6

Who most commonly presents with a shoulder dislocation?

Young adults
Elderly with weakened soft tissues

7

What is the most common direction for a shoulder to dislocate?

Anterior

8

By which mechanism does an anterior shoulder dislocation occur?

Fall backwards (shoulder externally rotated)

9

How must an anterior shoulder dislocation be assessed?

Badge area sensory assessment to rule out compression of the axillary nerve

10

By which mechanisms does a posterior shoulder dislocation occur?

Fall (shoulder internally rotated)
Direct blow to anterior shoulder

11

How does a patient with an inferior shoulder dislocation hold their arm?

In abduction

12

How must an inferior shoulder dislocation be assessed?

Prompt neurovascular assessment and reduction

13

What is the radiological sign indicating a posterior shoulder dislocation?

Light bulb sign

14

How is a shoulder dislocation managed?

Closed reduction under anaesthetic
Stabilisation
Rehabilitation

15

When might a shoulder dislocation be managed with an open reduction?

Fixed posterior dislocations

16

What is the main predictor of recurrent instability with a shoulder dislocation?

Age - the older the patient is the less likely it is to recur

17

What are the three main techniques of shoulder reduction?

Hippocratic, kocher's, in line traction

18

By which mechanism does an elbow dislocation occur?

Fall onto outstretched hand

19

Who gets elbow dislocations?

Adults
Children

20

In which directions can an elbow dislocate?

Anterior
Posterior
Medial
Lateral

21

What are the associated risks with an elbow dislocation?

Radial head fracture
Coronoid process fracture

22

By which mechanism does a radial head dislocation commonly occur?

Traction (pulling on the forearm)

23

Who gets radial head dislocation?

Children and infants

24

What is the risk for recurrent instability with an elbow dislocation?

Low

25

How is elbow dislocation managed?

Closed reduction under anaesthetic
2 weeks in a sling
Extensive rehabilitation

26

Why do elbow dislocations need to undergo rehabilitation?

They are prone to stiffness

27

How is an elbow dislocation reduced?

Traction in extension +/- pressure over olecranon

28

By which mechanisms do interphalangeal joint dislocations occur?

Hyperextension
Direct axial blow

29

In which direction does interphalangeal joint dislocation most commonly occur?

Posterior

30

What are the associated injuries of a dislocated interphalageal joint?

Phalangeal herniation through volar plate
Associated fracture --> recurrent instability

31

How are interphalangeal joint dislocations managed?

Closed reduction with digital/metacarpal block
2 weeks in neighbour strapping

32

How is an interphalangeal joint dislocation managed if it's unstabled?

Volar slab in edinburgh position

33

How are interphalangeal joint dislocations reduced?

In line traction with corrective pressure

34

What is the mechanism of patellar dislocation?

Sudden quadriceps contraction while the knee is bent

35

What is the direction of patellar dislocation?

Lateral

36

Who gets patellar dislocation?

Teenagers (girls)

37

What are the associations with patellar dislocation?

Hypermobility
Hypoplastic lateral femoral condyle
Increased Q-angle (genu valgum, femoral neck anteversion)
Lateral quads insertion
Weak vastus medialis

38

What is typically found on examination on patellar dislocation?

Medial pain
Patellar apprehension test positive
Effusion

39

What is the cause of the effusion in patellar dislocation?

Haemarthrosis

40

What is the cause of medial pain in patellar dislocation?

Torn medial retinaculum

41

How patellar dislocation managed?

Reduction on extension
Radiograph
Aspirate
Brace
Physiotherapy

42

How is repeat patellar dislocation managed?

Surgically - lateral release + medial reefing OR patellar tendon realignment

43

Are knee dislocations high or low velocity?

Most often high velocity

44

Can knee dislocations spontaneously relocate?

Yes

45

Which injuries indicated a knee dislocation that has spontaneously relocated?

Lateral collateral ligament injury
Peroneal nerve injury

46

Who typically gets knee dislocations?

Teenagers with ligamentous laxity (girls)

47

What directions can the knee dislocate?

Medial
Lateral
Rotatory
Posterior
Anterior

48

What is the most common direction the knee dislocates?

Posterior

49

What are the common vascular injuries caused by a knee dislocation?

Popliteal artery
Vein injury
Intimal tear/thrombus

50

What nerve gets injured with a knee dislocation?

Peroneal injury

51

How is a knee dislocation monitored for complications?

Normal exam - monitor
Clinical concern - arteriogram or MRI

52

How is ligamentous injury checked with knee dislocation?

Examination under anaesthetic

53

How is a knee dislocation managed?

Reduction under anaesthetic
Stabilise in splint/external fixation

54

When might surgical reduction be required for knee dislocation?

Condyle herniation through capsule

55

What type of imaging is indicated for knee dislocations and why?

X-rays for associated fractures
MRI

56

What type of early surgery is indicated for knee dislocations?

Vascular repair
Nerve repair

57

What type of definitive surgery is indicated for knee dislocations?

Sequential ligamentous repair

58

What are the possible complications of knee dislocation?

Post-traumatic arthritis and stiffness
Nerve/artery injury
Ligamentous laxity

59

What is the common mechanisms of hip dislocation?

RTA - dashboard injury
Fall from height
(High velocity)

60

What is the most common direction of hip dislocation?

Posterior

61

What are the fractures associated with hip dislocation?

Posterior acetabular wall
Femoral

62

How does a dislocated hip present?

Flexed
Internally rotated
Adducted knee

63

How is a hip dislocation managed?

Neurovascular assessment
X-ray
Urgent reduction
Possible stabilisation in-traction
Imaging/CT

64

What nerve is at risk in hip dislocation?

Sciatic

65

What are the complications of hip dislocation?

Sciatic nerve palsy
Avascular necrosis
Secondary osteoarthritis of the hip
Myositis ossificans

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