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Flashcards in Shoulder Deck (13):

What are 4 reduction methods for anterior shoulder dislocation

1. Scapular manipulation
2. External rotation
3. Milch - after external rotation, abduct and pressure in axilla on humeral head
4. Stimson (prone with weight for traction)
5. Cunningham (massage deltoids with gentle downward traction, patient shrugs shoulders back and moves scapula medially)


What are 5 complications of shoulder dislocation

Recurrent dislocation
Nerve injury - axillary or musculocutaneous
Fracture - Hill Sachs lesion or Bony Bankart, greater tuberosity
Labral tear
Vascular injury (axillary)


What is a Hill Sachs lesion?

Bony deformity in the head of the humerus from impaction against the glenoid during dislocation


What is a Bankart lesion?

Avulsion of the labrum (non bony) or glenoid (bony) during dislocation
Labral tear >>> bony bankart in younger individuals


What is a reverse Hill Sachs lesion

In posterior shoulder dislocations, an impaction fracture on the anteromedial humeral head


What is a contraindication to closed reduction of shoulder dislocations?

Fracture through the surgical neck of the humerus
Obtain orthopedic consultation


What is the mechanism of injury for an anterior shoulder dislocation (3)

1. indirect trauma with shoulder in abduction, extension and external rotation
2. direct impaction forces to posterior shoulder
3. convulsive mechanism (seizure, electric shock)


What is the mechanism of injury for a posterior shoulder dislocation

1. indirect trauma with shoulder in adduction, flexion and internal rotation
2. Electric shock or convulsive mechanism


How do posterior shoulder dislocations present?

Often missed injury
Typically held in traditional sling position of shoulder internal rotation and adduction

Best visualized on axillary Xray view


What is the mechanism of inferior glenohumeral dislocation? What population do we see this in?

Hyperabduction force with impingement of the neck of the humerus on the acromion
- levers the humeral head out inferiorly

Elderly patients


What is another name for inferior glenohumeral dislocation

Luxatio Erecto


What is inferior glenohumeral dislocation usually associated with?

Neurovascular compromise
Often recovers after reduction


How do patients with inferior glenohumeral dislocation present?

"Salute" position
Humerus locked in 110-160 degrees of abduction and forward elevation