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 :
- Dugas test
- Callway's test
- 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
