Shoulder Instability
Definition
Dislocation: complete loss of joint congruity and contact
Subluxation: partial d/l
Aetiology
Posterior shoulder dislocation
Clinical Features
Signs
Investigations
Imaging:
Management
Conservative
Posterior d/l
Non-conservative
Source
Dr Peter Van Winden
Dislocation: complete loss of joint congruity and contact
- Traumatic (TUBS) - common
- Atraumatic (AMBRI)
Subluxation: partial d/l
Aetiology
Posterior shoulder dislocation
- Seizures
- Electrocution
- Falls
- Direct blows
Clinical Features
Signs
- Neurovascular (Axillary n, axillary a, radial n)
Investigations
Imaging:
- X-Ray (2 or more projections)
- Post d/l: lightbulb sign
Management
Conservative
- Prompt reduction
- Kocher
- Hippocratic
- Gravity
- Elevation (least traumatic reduction)
- Scapular rotation
- Repeat neurovascular assessment
- Re-X ray
Posterior d/l
- Reduction
- If unstable, aeroplane splint
Non-conservative
- Surgery
Source
Dr Peter Van Winden