Shoulder Dislocation

Question 1

What is a shoulder dislocation?

Answer 1

Humeral head dislodging from glenoid cavity of scapula

Question 2

What are the 2 types of shoulder dislocation?

Answer 2

1. Anterior inferior (95%)
2. Posterior inferior (5%) (seizures)

Question 3

What are the clinical features of a shoulder dislocation? (3 things)

Answer 3

1. Pain
2. Reduced mobility
3. Feeling of instability

Question 4

What should you check for in examination of a shoulder dislocation? (4 things)

Answer 4

1. Asymmetry (w contralateral side)
2. Loss of shoulder contour (bc flattened deltoid)
3. Anterior bulge (bc humerus head)
4. Neurovasc status of arm (esp axillary + suprascap n)

Question 5

When should you check for neurovasc status in shoulder dislocation? (2 things)

Answer 5

1. Pre-reduction
2. Post reduction

Question 6

What are some associated injuries with shoulder dislocation? (2 things)

Answer 6

1. Bony Bankart lesion = detachment of ant. labrum from glenoid
2. Hill Sachs = osteochondral depression #

Question 7

What investigation should be done for a shoulder dislocation?

Answer 7

Plain XR (AP + lat)

Question 8

What will a AP view plain XR show in an ANTERIOR shoulder dislocation?

Answer 8

1. Humeral head visibly out of glenoid fossa (CAN see greater tubercle)
2. Humeral head overlaps w other bony structures (aka no GAP)

Question 9

What will a AP view plain XR show in a POSTERIOR shoulder dislocation? (2 things)

Answer 9

1. “Light bulb sign” = humerus fixed in internal rotation (aka CAN’T see greater tubercle)
2. Gap between humerus and glenoid (no overlapping)

Question 10

What is a Lat view plain XR used for in a shoulder dislocation?

Answer 10

To differentiate between ANT + POST dislocations

Question 11

What is the initial management of a shoulder dislocation? (2 things)

Answer 11

1. A-E
2. Analgesia

Question 12

What are the management options for a shoulder dislocation? (6 things)

Answer 12

1. Reduction
2. Immobilisation
3. Rehab
4. MUA
5. Broad arm sling
6. Physio

Question 13

When should MUA be done for a shoulder dislocation?

Answer 13

If closed reduction fails

Question 14

When should a Broad arm sling be used for shoulder dislocation?

Answer 14

After reduction

Question 15

What is the purpose of physiotherapy for shoulder dislocation? (2 things)

Answer 15

1. Restores range of movement
2. Strengthens rotator cuff muscles

Question 16

What are the complications of shoulder dislocations? (6 things)

Answer 16

1. Chronic pain + stiffness
2. Limited mobility
3. Nerve damage
4. Adhesive capsulitis
5. Rotator cuff injury
6. Recurrence