Shoulder dislocation

Swelling

Head palpable

position of extremity

Anterior test

      Duga's test

      Ruler test

      Callaway test


Neurological impairment

Instability

      Fulcrum test

     apprehension

      Jobe's relocation test

      Jerk test

      Drawer test

       Sulcus test

Investigations

      AP view

      Scapular view

       lateral view

                       information about direction of dislocation , fracture , blocks for relocation


     Stryker notch view - for humeral head defects

     
     West point axillary view - shows notch defects


       CT scan - shows detailed anatomy

       MRI - associated rotator cuff tear and labral tears


        Arhtroscopy -  invasive

                                difficult atraumatic structural and muscle pattern in non structural cases


        EMG - atraumatic complex instability situation


Treatment

 Urgent reduction

 1. Stimson method - prone , downward traction

 2. Kocher method - Redislocation rates higher

 3. Spaso technique - supine and ER and long traction

 4. Hippocratic

 5. Traction and countertraction


Open reduction for old dislocation

 Intelligent neglect - for old dislocation with good functional range


Post reduction check congruency , stability , immobilize

Later assess apprehension , cuff muscles


Complication

       Recurrence - as high as 90 % in < 20 years

                           in external rotation immobilization - low recurrence rate







                   







































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