Approach to Shoulder Dislocation | ASON Webinar 3 was much discussion topic during the webinar with lots of good knowledge.
Shoulder dislocation is one of the most common dislocations that orthopedic surgeons came across during the hospitals. The most common dislocation is shoulder dislocation anterior mostly. Besides, there could be posterior shoulder dislocation as well. Sometimes we can also define shoulder dislocation as complete shoulder dislocation or partial shoulder dislocation.
The video is generally focused on the approach to shoulder dislocation. How to approach and how to do the treatment for the shoulder dislocation.
The basic management of shoulder dislocation anterior or others is the immediate reduction of the shoulder then to immobilization. Let’s know the basics regarding how to fix shoulder dislocation and exercise for shoulder dislocation in this video
Some brief points to ponder from the video
acute dislocation or recurrent dislocation –> immobilize to with arm sling is about one week or two-week immobilization is ok
For fracture Dislocation of the shoulder with GT Fracture approach
- always rule out neurovascular injury and watch for shoulder dislocation symptoms
- the preoperative recording is need
- after reduction –> neurovascular assessment
- if GT is ok –> no other investigations
- If GT fracture or other fracture–> repeat after 7-10 days
- if available–> Do CT scan
- Displacement of GT > 5mm is in need of surgery or fixation
- GT fracture shouldn’t be taken simple
- Person if not able to do abduction of the shoulder–> suspect of hairline GT fracture) or rotator cuff tear
The first dislocation treatment approach
If young with high activity –> treatment for the fixing primary bankart.
Doing the examination of the shoulder dislocation is really necessary?
Shoulder dislocations Tests
Test on Shoulder dislocation and investigation on shoulder dislocation is done with the patient with shoulder dislocation symptoms
The bone apprehension test ( mid-range stability test) is a better instability test for assessing the glenoid pathology
Other tests are
- sulcus test
- relocations test
- apprehension test
- release or surprise test
- load and shift test
- drawer tests
Rotator Cuff Tear, scapular dyskinesia, traditional and mid-range apprehension test are important in shoulder dislocation
Investigation for Shoulder dislocation
Xray followed by CT / MRI
True AP view, Axiallay view ( if not possible), velpeau axially views, Axillary view, AP view of glenoid with the humerus in internal rotation view, maximal external rotation view, west point view, stryker notch view
loss of sclerotic Glenoid line(SGL) in AP view –> diagnostic sign of osseous defect of the anterior glenoid rim
AP with internal rotation–> for hill sach lesion
if bone loss–> Do CT scan and if no bone loss–> MRI
so, for as far as possible –> do both CT and MRI