Shoulder dislocation: Difference between revisions
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==Background== | ==Background== | ||
*Humerus separates from the scapula at the glenohumeral joint. | |||
*Partial dislocation of the shoulder is referred to as subluxation. | |||
==Types== | ==Types== | ||
Revision as of 06:14, 4 April 2015
Background
- Humerus separates from the scapula at the glenohumeral joint.
- Partial dislocation of the shoulder is referred to as subluxation.
Types
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]
Differential Diagnosis
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
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
- 20 mL of 1% lidocaine intra-articular injection[4]
See Also
Sources
- ↑ Calvet, E et al. [Dislocations of the shoulder and vascular le- sions.] (in French). J Chir (Paris) 1941; 58: 337-346.
- ↑ 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.
- ↑ Sahajpal DT, et al. Chronic glenohumeral dislocation. J Am Acad Orthop Surg. 2008 Jul;16(7):385-98.
- ↑ 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