Difference between revisions of "Posterior shoulder dislocation"

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==Background==
 
==Background==
*Via forceful internal rotation/adduction (sz, electric shock) or blow to ant shoulder
+
*Accounts for 2-4% of shoulder dislocations<ref>Grate I Jr. Luxatio erecta: a rarely seen, but often missed shoulder dislocation. Am J Emerg Med. 2000 May;18(3):317-21.</ref>
 +
*MOI - forceful internal rotation/adduction (2/2 e.g. seizure, electric shock) or blow to ant shoulder
 
*Neurovascular and rotator cuff tears are less common than in ant dislocations
 
*Neurovascular and rotator cuff tears are less common than in ant dislocations
  
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==Management==
 
==Management==
 
*Reduce
 
*Reduce
 +
**Consider [[procedural sedation]]
 
**Traction applied to adducted arm in long axis of humerus
 
**Traction applied to adducted arm in long axis of humerus
 
**Assistant pushes humeral head anteriorly into glenoid fossa
 
**Assistant pushes humeral head anteriorly into glenoid fossa
*Sling and swath
+
*Post-reduction X-ray
 +
*Apply sling
  
 
==Disposition==
 
==Disposition==

Revision as of 22:16, 4 July 2015

Background

  • Accounts for 2-4% of shoulder dislocations[1]
  • MOI - forceful internal rotation/adduction (2/2 e.g. seizure, electric shock) or blow to ant shoulder
  • Neurovascular and rotator cuff tears are less common than in ant dislocations

Clinical Features

  • Prominence of posterior shoulder and ant flattening of normal shoulder contour
  • Pt unable to rotate or abduct affected arm

Differential Diagnosis

Shoulder and Upper Arm Diagnoses

Traumatic/Acute:

Nontraumatic/Chronic:

Refered pain & non-orthopedic causes:

Diagnosis

  • Plain film X-ray
    • Scapular "Y" view shows humeral head in posterior position

Management

  • Reduce
    • Consider procedural sedation
    • Traction applied to adducted arm in long axis of humerus
    • Assistant pushes humeral head anteriorly into glenoid fossa
  • Post-reduction X-ray
  • Apply sling

Disposition

  • Discharge after reduction
  • Ortho follow-up

See Also

References

  1. Grate I Jr. Luxatio erecta: a rarely seen, but often missed shoulder dislocation. Am J Emerg Med. 2000 May;18(3):317-21.