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Shoulder (Shoulder Dislocation (Posterior Shoulder Dislocation (5%)…
Shoulder
Shoulder Dislocation
- complete separation of the glenohumeral joint.
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Prognosis
- recurrence rate depends on age of first dislocation:
<20yr= 95%; 20-40yr= 70%; >40yr= 4%
Complications
- recurrent / unreduced dislocation (most common)
- injury to axillary nerve/artery, brachial plexus
- rotator cuff or capsular or labral tear (Bankart/SLAPlesion)
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Acromioclavicular Joint
- subluxation or dislocation of AC joint.
- 2 main ligaments attach clavicle to scapula: AC and CC ligaments
- Mechanism: fall on to shoulder with adducted arm or direct trauma to point of shoulder
- Features:
pain with adduction of shoulder and/or palpation over AC joint
limited ROM
- Investigations: x-rays: bilateral AP, Zanca view (10-15° cephalic tilt), axillary.
- Treatment:
sling 1-3 wk, ice, analgesia, early ROM and rehabilitation
operative:
indication: Rockwood Class IV-VI (III if labourer or high level athlete)
Clavicle Fracture
- incidence: proximal (5%), middle (80%), or distal (15%) third of clavicle
- common in children (unites rapidly without complications)
- Mechanism: fall on shoulder (87%),direct trauma to clavicle (7%), FOOSH (6%)
- Features: Pain, and tenting of skin
- Investigations: x-ray:AP, CT
- Treatment:
simple sling
Operative treatment – open reduction and internal fixation with K-wires / AO plate