Cheatography
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Presentation, Management etc
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Classifications
- Can occur anterior, posterior/inferior
- Mainly anterior due to less muscular and ligamentous support |
- Anterior dislocations are in 4 types based on resting position of the humeral head
Subcoracoid
Subglenoid
Subclavicular
Intrathoracic |
- Subcoracoid and Subglenoid most common |
- Majority of inferior dislocations have brachial plexus injury and rotator cuff tears |
Presentation
- Traumatic onset - fall that forces excessive ext rot or abduction |
- Acute shoulder pain - patient cradles arm and won't move it |
- Bulge of humeral head in anterior dislocation |
- Muscle spasm over area |
- Assess axillary nerve, radial nerve and axillary artery (pulses, capillary refil, peripheral cyanosis, coolness, pallor) |
Imaging
- Ant shoulder dislocation
- Indicated for traumatic onsets and first time dislocations
- >40 years old and forceful trauma
- Not usually necessary in younger patients with anterior dislocation and no neurovascular concern
Management
- Reduction , refer to A&E |
- Surgery is needed if subclavicular, intrathoracic dislocation, dislocations with associated f# and neurovascular compromise |
- Sling up to four weeks |
- Gentle ROM exercises and strengthening |
- High rate of recurrence |
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