Shoulder dislocation: Difference between revisions
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==Background== | |||
*>99% are anterior dislocation assoc w/ indirect blow | |||
*Must rule-out axillary nerve injury | |||
*Consider intra-articular lidocaine (10-20mL) as alternative to procedural sedation | |||
==Clinical Features== | |||
*Arm held in abduction w/ shoulder lacking normal rounded contour | |||
*Difficulty (painful) touching ipsilateral arm to contralateral shoulder | |||
==Imaging== | |||
*Prereduction radiographs advised for traumatic mechanism (rule-out fx-dislocation) | |||
*AP | |||
**Will show dislocation | |||
*Scapular lateral or "Y" | |||
**Will show whether dislocation is anterior or posterior | |||
==Reduction Techniques== | |||
*Traction-Countertraction | |||
[[File:Traction-Countertraction.jpg]] | |||
*Milch | |||
[[File:Milch.jpg]] | |||
*External Rotation | |||
[[File:External Rotation.jpg]] | |||
**Types: | |||
***Subcoracoid | |||
***Subglenoid | |||
***Subclavicular | |||
***Intrathoracic | |||
When the shoulder is anteriorly dislocated, two additional nerves, the axillary (supplying sensation to the lateral aspect of the shoulder) and the musculocutaneous (supplying sensation to the extensor aspect of the forearm), also should be checked. | When the shoulder is anteriorly dislocated, two additional nerves, the axillary (supplying sensation to the lateral aspect of the shoulder) and the musculocutaneous (supplying sensation to the extensor aspect of the forearm), also should be checked. | ||
*Dislocation + proximal humerus fx require ortho consult | |||
==Management== | |||
==Source== | ==Source== | ||
Tintinalli | *Tintinalli | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 02:44, 11 February 2012
Background
- >99% are anterior dislocation assoc w/ indirect blow
- Must rule-out axillary nerve injury
- Consider intra-articular lidocaine (10-20mL) as alternative to procedural sedation
Clinical Features
- Arm held in abduction w/ shoulder lacking normal rounded contour
- Difficulty (painful) touching ipsilateral arm to contralateral shoulder
Imaging
- Prereduction radiographs advised for traumatic mechanism (rule-out fx-dislocation)
- AP
- Will show dislocation
- Scapular lateral or "Y"
- Will show whether dislocation is anterior or posterior
Reduction Techniques
- Traction-Countertraction
- Milch
- External Rotation
- Types:
- Subcoracoid
- Subglenoid
- Subclavicular
- Intrathoracic
- Types:
When the shoulder is anteriorly dislocated, two additional nerves, the axillary (supplying sensation to the lateral aspect of the shoulder) and the musculocutaneous (supplying sensation to the extensor aspect of the forearm), also should be checked.
- Dislocation + proximal humerus fx require ortho consult
Management
Source
- Tintinalli