Shoulder dislocation: Difference between revisions

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==Management==
==Management==
*See individual type
*See individual types for specific management
 
*Cochrane review notes lower complications, equal pain control, and shorter ED stay with intra-articular lidocaine vs. procedural sedation<
**20mL of 1% lidocaine intra-articular injection<ref>Intra-articular lignocaine versus intravenous analgesia with or without sedation for manual reduction of acute anterior shoulder dislocation in adults (Review) Cochrane Database Syst Rev. 2011 Apr 13;(4):CD004919 [http://www.update-software.com/BCP/WileyPDF/EN/CD004919.pdf full text]</ref>


==See Also==
==See Also==

Revision as of 20:35, 28 March 2015

Background

Chronic Anterior Dislocation

Calvet describes a high risk of axillary artery rupture in chronic dislocation (68 out of 91 chronic anterior shoulder dislocations)[1]Verhaegen reported two cases of axillary artery rupture in patients with reduction of a chronic shoulder dislocation (12 weeks)[2] A safe rule would be orthopedic consultation and proceed with caution in patients with 3-4 week dislocation[3]

Types

Differential Diagnosis

Shoulder and Upper Arm Diagnoses

Traumatic/Acute:

Nontraumatic/Chronic:

Refered pain & non-orthopedic causes:

Management

  • See individual types for specific management
  • Cochrane review notes lower complications, equal pain control, and shorter ED stay with intra-articular lidocaine vs. procedural sedation<
    • 20mL of 1% lidocaine intra-articular injection[4]

See Also

Sources

  1. Calvet, E et al. [Dislocations of the shoulder and vascular le- sions.] (in French). J Chir (Paris) 1941; 58: 337-346.
  2. Verhaegen F, et al. Chronic anterior shoulder dislocation: as- pects of current management and potential complications. Acta Orthop Belg. 2012 Jun;78(3):291-5. PMID: 22822566.
  3. Sahajpal DT, et al. Chronic glenohumeral dislocation. J Am Acad Orthop Surg. 2008 Jul;16(7):385-98.
  4. Intra-articular lignocaine versus intravenous analgesia with or without sedation for manual reduction of acute anterior shoulder dislocation in adults (Review) Cochrane Database Syst Rev. 2011 Apr 13;(4):CD004919 full text


External Links