Shoulder dislocation: Difference between revisions
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(Moved "chronic anterior dislocation" section to anterior dislocation article.) |
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*Partial dislocation of the shoulder is referred to as subluxation. | *Partial dislocation of the shoulder is referred to as subluxation. | ||
==Types== | ===Types=== | ||
*[[Anterior shoulder dislocation]] | |||
*[[Posterior shoulder dislocation]] | |||
*[[Inferior shoulder dislocation]] | |||
== | ==Diagnosis== | ||
* | *Plain film X-ray | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 18: | Line 15: | ||
==Management== | ==Management== | ||
*See individual types for specific management | *Reduction | ||
**See individual types for specific management | |||
*Cochrane review notes lower complications, equal pain control, and shorter ED stay with intra-articular lidocaine vs. procedural sedation | *Cochrane review notes lower complications, equal pain control, and shorter ED stay with intra-articular lidocaine vs. procedural sedation | ||
**20 mL of 1% lidocaine intra-articular injection<ref>Intra-articular lignocaine versus intravenous analgesia with or without sedation for manual reduction of acute anterior shoulder dislocation in adults (Review) Cochrane Database Syst Rev. 2011 Apr 13;(4):CD004919 [http://www.update-software.com/BCP/WileyPDF/EN/CD004919.pdf full text]</ref> | **20 mL of 1% lidocaine intra-articular injection<ref>Intra-articular lignocaine versus intravenous analgesia with or without sedation for manual reduction of acute anterior shoulder dislocation in adults (Review) Cochrane Database Syst Rev. 2011 Apr 13;(4):CD004919 [http://www.update-software.com/BCP/WileyPDF/EN/CD004919.pdf full text]</ref> | ||
==Disposition== | |||
*Uncomplicated dislocation can be discharged after reduction. | |||
==See Also== | ==See Also== | ||
*[[Shoulder diagnoses]] | *[[Shoulder diagnoses]] | ||
==External Links== | ==External Links== | ||
*[http://www.youtube.com/watch?v=d9HjtQr0c64 Good all-round shoulder reduction technique lecture] | *[http://www.youtube.com/watch?v=d9HjtQr0c64 Good all-round shoulder reduction technique lecture] | ||
*[http://thecentralline.org/?p=1769 Keeping Up in EM Shoulder Reduction Video] | *[http://thecentralline.org/?p=1769 Keeping Up in EM Shoulder Reduction Video] | ||
==References== | |||
<references/> | |||
[[Category:Ortho]] | [[Category:Ortho]] | ||
[[Category:Procedures]] | |||
Revision as of 08:40, 4 July 2015
Background
- Humerus separates from the scapula at the glenohumeral joint.
- Partial dislocation of the shoulder is referred to as subluxation.
Types
Diagnosis
- Plain film X-ray
Differential Diagnosis
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Management
- Reduction
- See individual types for specific management
- Cochrane review notes lower complications, equal pain control, and shorter ED stay with intra-articular lidocaine vs. procedural sedation
- 20 mL of 1% lidocaine intra-articular injection[1]
Disposition
- Uncomplicated dislocation can be discharged after reduction.