Dislocation of shoulder

Imp. Points about shoulder dislocation :

• MC joint in body to dislocate
  
• MC joint to undergon recurrent dislocation
  
• MC type of dislocation is anterior
  
• MC type of anterior is subcoracoid
  
• MC method of reduction : Kocher's manoeuver
  
• MC c/c : axillary nerve injury (loss of sensation and absence of deltoids contraction)
  
• MC late c/c : recurrent dislocation (causes of recurrence : a) shallow glenoid labrum b) injury to humeral head)
  
• MC nerve injured : axillary nerve
  

Luxatio erecta :

• Head in subglenoid position
  
• Inferior dislocation of shoulder
  

Mechanism of ant. dislocation :

• Fall on out stretched hand with the shoulder abducted and externally rotated.
  

Lesions :

• Bankert's lesion : stipping of anterior surface of glenoid labrum
  
• Hill-sach'sn lesion : depression on the humerus head in its posterolateral quadrant.
  
• X-ray : associated fractureof greater tuberosity of humerous
  
• Roundning off of the anterior glenoid rim
  
• Hatchat head apearance
  
• Recurrent shoulder dislocation
  

On examination :

• Shoulder abducted
  
• Shoulder joit : flattend (normal  contour lost)
  
• Fullness below the clavicle
  

Complications :

• Early : axillary nerve injury
  
• Late : recurrent dislocation [ causes : marfan's syndrome,inadequate treatment,epileptic patients etc.)
  

Tests :

1. Dugas test
   
2. Callway's test
   
3. Hmilton ruler test
   

Techniques of reduction :

• Kocher's maneuver [ TEA-I : Traction/External rotation/Adduction/Internal rotation ]
  
• Hippocrates maneuver
  

Operations :

• Putti-platt operation
  
• Bankart's operation
  
• Bristow's operation
  
• Arthoscopic bankart's repair