Shoulder dislocation: Difference between revisions

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**[[Posterior shoulder dislocation]]
**[[Posterior shoulder dislocation]]
**[[Inferior shoulder dislocation]]
**[[Inferior shoulder dislocation]]
==Posterior Dislocation==
===Background===
*Via forceful internal rotation/adduction (sz, electric shock) or blow to ant shoulder
*Neurovascular and rotator cuff tears are less common than in ant dislocations
===Clinical Features===
*Prominence of posterior shoulder and ant flattening of normal shoulder contour
*Pt unable to rotate or abduct affected arm
===Imaging===
*Scapular "Y" view shows humeral head in posterior position
===Management===
*Reduce
**Traction applied to adducted arm in long axis of humerus
**Assistant pushes humeral head anteriorly into glenoid fossa
*Spling, ortho f/u


==Inferior Dislocation==
==Inferior Dislocation==

Revision as of 04:34, 18 February 2015

Background

  • Cochrane review notes lower complications, equal pain control, and shorter ED stay with intra-articular lidocaine vs. procedural sedation
    • 20mL of 1% lidocaine intra-articular injection

Types

Inferior Dislocation

Background

  • Assoc w/ significant soft tissue trauma or fracture
  • Via hyperabduction force which levers the humeral neck against the acromion

Clinical Features

  • Pt p/w humerus fully abducted with hand on or behind the head
  • Humeral head can be palpated on lateral chest wall

Management

  • Reduce
    • Traction in upward and outward direction
  • Sling, ortho f/u (rotator cuff tear is the norm)

Further Reading

Good all-round shoulder reduction technique lecture

Keeping Up in EM Shoulder Reduction Video

References

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