1 / 30

Glenohumeral Dislocation: Class, Complications and Management

Glenohumeral Dislocation: Class, Complications and Management. August 21, 2003 Emergency XR Rounds Simon Pulfrey (with much gleaned from Dave Dyck). Normal. Diagnostic Strategies. 1- True AP. 2. Axillary. Transcapular or “Y” View. Post reduction:. Hill-Sachs. Post reduction. Bankhart.

oistin
Download Presentation

Glenohumeral Dislocation: Class, Complications and Management

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Glenohumeral Dislocation: Class, Complications and Management August 21, 2003 Emergency XR Rounds Simon Pulfrey (with much gleaned from Dave Dyck)

  2. Normal

  3. Diagnostic Strategies • 1- True AP

  4. 2. Axillary

  5. Transcapular or “Y” View

  6. Post reduction:

  7. Hill-Sachs

  8. Post reduction

  9. Bankhart

  10. Complications of anterior glenohumeral dislocation and reduction • Neurovascular – neuropraxic and recover in days-weeks • Fractures • Hill-Sachs – 11-50% of ant dislocations. May be higher if consider minor compression fractures • Bankart – ant glenoid rim #. 5% of cases. • Avulsion # of greater tuberosity in 10-15%.

  11. Complications of anterior glenohumeral dislocation and reduction • Rotator cuff injury – 10-15% will have tear. Higher incidence in those >40yrs. • Capsulolabral avulsions in those of younger years

  12. Infraglenoid Dislocation + Hill-Sachs Fracture

  13. Luxatio Erecta:

  14. Luxatio Erecta • 0.5% • Usually axial load on abducted arm or indirect trauma • Presents with 100-160 deg of abduction • Humeral shafts lies parallel to spine of scapula (infglenoid lies against chest wall) • Usually need ortho help • Wary buttonhole problem

  15. Posterior Dislocation: -trough sign. Reverse Hill-Sach# on ante-medial hh. -Lightbulb/drum stick

  16. Posterior Dislocation • Rare. 2%. • Commonly missed (50%!) • Seizures, fall on flexed and adducted arm, direct blow • Deceptively normal-appearing AP XR • Increased importance of clinical exam

  17. Clinical Findings: • Arm adducted and internally rotated • The anterior shoulder is flat and the posterior aspect full • Prominent coracoid • The patient won’t allow abduction or external rotation

  18. Rim sign: ant glenoid rim and articular surface of hh increased (usu>6mm)

  19. Summary • Reduce ASAP • Wary neurovascular status, fractures & rotator cuff injuries • Consider necessity of pre & post reduction films on an individual basis • Know well three methods of reduction • Suspect posterior dislocations in appropriate pts

More Related