shoulder dislocation

Question 1

what happens in shoulder dislocation

Answer 1

humeral head dislodges from the glenoid cavity of the scapula.

Question 2

position of arm in shoulder dislocation

Answer 2

anterior: arm in external rotation and slight abduction
posterior: adduction and internal rotation - shoulder cannot be abducted
inferior - arm fully abducted and elbow flexed on or behind head

Question 3

sx and signs of shoulder dislocation

Answer 3

pain
inability to move joint
tender
swelling
normal neuro

Question 4

ix for shoulder dislocation

Answer 4

AP XR with internal and external humeral rotation
axillary lateral and/or scapular Y views to confirm diagnosis.

Question 6

Answer 6

Scapular Y x-ray view showing an anterior fracture dislocation of the shoulder and fracture of the greater tuberosityPersonal collec

Question 7

Answer 7

anteroinferior dislocation (AP XR)

Question 8

Answer 8

Anteroposterior x-ray view of a shoulder showing a missed posterior dislocation: the glenohumeral joint appears reduced

Question 9

Answer 9

Axillary lateral of a shoulder with a missed posterior dislocation: humeral head clearly is not reduced and is locked on the posterior rim of the glenoid

Question 10

mx of shoulder dislocation

Answer 10

reduction and immobilisation +- surgical referral
* refer under 25yrs - risk of recur
* reduction under LA and procedural sedation

reduction
* abduction and external rotation to disengage the humoral head
* axial traction to reduce it

immobilise and place in sling 3wks

AP XR to confirm position

neurovascular exam

rehab

Question 11

complications of shoulder dislocation

Answer 11

recurrent instability of shoulder joint
hill-sachs lesion - compression fracture on the posterolateral corner of the humeral head, which is caused when the humeral head impinges against the glenoid (scapula) of the shoulder joint
bankarts lesion - avulsion of glenoid labrum