Shoulder dislocation

Question 1

Which type of shoulder dislocation is more common - anterior or posterior?

Answer 1

Anterior (95% of cases)

Question 2

What are the general features of shoulder dislocation?

Answer 2

• Severe shoulder pain
• Inability to move the shoulder
• Empty glenoid fossa

Question 3

What are the clinical features specific to anterior shoulder dislocation?

Answer 3

• Humeral head can usually be palpated below the coracoid process
• Arm is typically held in external rotation and slight abduction

Question 4

What are the clinical features specific to posterior shoulder dislocation?

Answer 4

• Prominence of the posterior shoulder with anterior flattening
• Prominent coracoid process
• Arm is held in adduction and internal rotation, with patient unable to actively rotate it outwards

Question 5

Describe the x-ray findings for anterior and posterior shoulder dislocations.

Answer 5

Anterior:
- Hill-Sachs lesion (little notch in humeral head; seen in 35-40% of cases)

Posterior:
- lightbulb sign

Question 6

How are shoulder dislocations typically managed?

Answer 6

Closed reduction and sling

Question 7

What are the indications for surgical management of shoulder dislocation?

Answer 7

• Unsuccessful closed reduction
• Concomitant dislocated fracture of humerus, clavicle, or scapula
• Displace Bankart lesion
• Recurrent shoulder dislocations
• Young and active individuals may require early surgery to prevent recurrent dislocations in the future

Question 8

What are the potential complications of shoulder dislocation?

Answer 8

• Axillary nerve damage
• Injury to brachial plexus
• Avulsion fracture of the major and/or minor tubercles
• Shoulder joint instability
• Rotator cuff injury
• Shoulder stiffness
• OA of shoulder joint