Most commonly dislocating joint: Shoulder joint
- Vitamin We
- Jun 4, 2020
- 2 min read
Updated: Jun 5, 2020
Shoulder dislocation
Most common joint to get dislocated in the human body. This is because shoulder joint is an unstable joint.
Shoulder instability:
Minor: “loose shoulder” in which there is just pai on movement of he joint.
Major: ”subluxation or dislocation” in which there is pain on even a slightest of movement and there is abnormal movent i different directions.
Mechanism: fall on an outstetched hand with shoulder abducted and externally rotated. Anterior dislocation is way more commoner.
Classification:
1. Anterior dislocation: the head of the humerus comes out of the glenoid cavity and lies anteriorly.
· Preglenoid: head lies in front of glenoid.
· Subcracoid: head lies beneath the coracoid process.
· Subclavicular: head lies below the clavicle.
2. Posterior disloaction :head lies posterior to the glenoid cavity.
3. Inferior dislocation:head lies in the subglenoid position.
Pathological changes:
BANKART’S LESION : dislocation causes stripping of the glenoid labrum and the perostium but in severe injuries, avulsion of a part of glenoid rim may occur called “bankart’s lesion”.
HILL SACH’S LESION: this is a depression in posterior part of head of humerus because of the dislocation.
“Rounding off” of the anterior glenoid rim.
Associated injuries of the soft tissues.
CLINICAL FEATURES:
h/o fall on outstretched hand.
Shouldr abducted and elbow supported by the other hand.
Pain and inability to move the hand.
EXAMINATION:
Normal round shape of shoulder is lost and has become flattened. Fullness is felt near the clavicle due to displaced head.
Duga’s test: Unable to touch opposite shoulder.
Hamilton ruler test: ruler kept on the shoulder touches the acromian and lateral condyle simultaneously.
Xray used to confirm the diagnosis.
TECHNIQUES OF REDUCTION OF THE DISLOCATION:
1. KOCHER’S MANOEUVRE:
· Elbow flexed at right angle and traction is applied.
· Externally rotate the arm
· Arm is adducted
· Internal rotation
2. HIPPOCRATES MANOEUVRE:
· Firm and steady pull on the semi abducted arm with is foot in axilla. Head is levered back into the cavity using foot as fulcrum.
TREATMENT:
1.BANKARTS OPERATION:
Glenoid labrum and capsule are reattached in front of the glenoid cavity.
2.ARTHROSCOPIC BANKARTS OPERATION:
Arthroscopic repair is faster and better and is cosmetically better.
Comments