Understanding Joints Dislocation

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Questions and Answers

What is the main symptom associated with a shoulder dislocation?

  • Muscle spasms in the shoulder
  • Numbness in the fingers
  • Severe shoulder pain (correct)
  • Swelling of the shoulder

Which classification describes a shoulder dislocation that is caused by traumatic events and requires surgery?

  • Multidirectional instability
  • Bilateral dislocation
  • TUBS (correct)
  • AMBRI

What is the role of the rotator cuff in shoulder stability?

  • Only responsible for shoulder movement
  • Static stabilizer through ligament tightening
  • Provides bony stability through glenoid bone stock
  • Dynamic stabilizer through passive muscle tension (correct)

Which of the following factors is the primary risk for dislocating the shoulder?

<p>Previous shoulder dislocation (A)</p> Signup and view all the answers

What pathology is commonly associated with a traumatic anterior shoulder dislocation?

<p>Bankart lesion (B)</p> Signup and view all the answers

Which condition would indicate that surgery is required after conservative measures fail for a shoulder dislocation?

<p>Inferior capsular shift (B)</p> Signup and view all the answers

Which sport is associated with a higher incidence of shoulder dislocations due to frequent contact impacts?

<p>Rugby (B)</p> Signup and view all the answers

What is a common physical sign observed in someone with a dislocated shoulder?

<p>Arm held close to trunk with elbow flexed (B)</p> Signup and view all the answers

What is the most common type of shoulder dislocation?

<p>Anterior dislocation (A)</p> Signup and view all the answers

Which method is used for closed reduction of acute shoulder dislocation?

<p>Hippocratis' technique (A)</p> Signup and view all the answers

What should be examined to assess for neurovascular injury in shoulder dislocation?

<p>Contraction of the deltoid muscle (D)</p> Signup and view all the answers

What is a potential complication of lunate dislocation?

<p>Carpal tunnel syndrome (B)</p> Signup and view all the answers

Which characteristic is NOT associated with anterior shoulder dislocation?

<p>Swelling of the elbow (D)</p> Signup and view all the answers

In which circumstance is open reduction indicated for shoulder dislocation?

<p>If closed reduction fails (C)</p> Signup and view all the answers

What is the risk associated with shoulder dislocation related to the axillary nerve?

<p>Nerve injury affecting shoulder movement (C)</p> Signup and view all the answers

Which classification of shoulder dislocation is considered rare?

<p>Inferior dislocation (D)</p> Signup and view all the answers

What is typically visible or palpable when there is a loss of the normal contour of the shoulder?

<p>Anterior bulge of the head of the humerus (B)</p> Signup and view all the answers

What is the first step in the nonoperative treatment of a dislocated shoulder?

<p>Performing a closed reduction under anaesthesia (A)</p> Signup and view all the answers

Which technique is NOT used for closed reduction of a dislocated shoulder?

<p>Smith's technique (C)</p> Signup and view all the answers

What role does physiotherapy play after shoulder dislocation treatment?

<p>Aids in restoring range of motion and strengthening muscles (C)</p> Signup and view all the answers

Which of the following is a recommended approach to shoulder rehabilitation?

<p>Ergonometric postural correction (D)</p> Signup and view all the answers

What is the purpose of using a sling after a shoulder dislocation?

<p>To support the arm and prevent movement (A)</p> Signup and view all the answers

In the context of joint dislocation prevention, which of the following is NOT advisable?

<p>Avoiding exercises that strengthen muscles (B)</p> Signup and view all the answers

Which type of dislocation is the most common for the elbow?

<p>Posterior dislocation (C)</p> Signup and view all the answers

What is the most common type of elbow dislocation?

<p>Posterior dislocation of both bones (D)</p> Signup and view all the answers

Which mechanism of injury most commonly leads to a posterior elbow dislocation?

<p>Fall on an outstretched hand (A)</p> Signup and view all the answers

Which complication can result from neglected mobilization after elbow dislocation?

<p>Stiffness of the elbow joint (A)</p> Signup and view all the answers

What is the primary focus of initial treatment for an elbow dislocation?

<p>Urgent closed reduction (D)</p> Signup and view all the answers

What anatomical feature is disrupted during an elbow dislocation?

<p>Medial and lateral collateral ligaments (D)</p> Signup and view all the answers

Which feature serves as an indicator of an elbow dislocation during clinical examination?

<p>Isosceles triangle formed by epicondyles (D)</p> Signup and view all the answers

What should be avoided in the post-treatment care of an elbow dislocation to prevent complications?

<p>All of the above (D)</p> Signup and view all the answers

What ensures a high degree of stability in the elbow joint?

<p>Joint congruity and opposing tension (C)</p> Signup and view all the answers

Flashcards

Shoulder Dislocation

A serious injury where the shoulder joint's bones are forced out of their normal alignment.

TUBS Classification

A classification of shoulder dislocations related to traumatic causes and unidirectional instability, requiring surgery

AMBRI Classification

A classification of shoulder dislocations related to atraumatic causes and multidirectional instability, often treated with rehabilitation

Bankart Lesion

A tear in the shoulder labrum and capsule, a common injury following traumatic anterior dislocation

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Rotator Cuff

A group of muscles surrounding the shoulder joint that provide dynamic stability and movement.

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Clinical Picture (dislocation)

The visible signs and symptoms of a dislocated shoulder, including severe pain, swelling, and limited movement.

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Risk Factors (shoulder dislocation)

Conditions or factors that increase the chance of a shoulder dislocation, such as previous dislocation, certain sporting activities, and weakened muscles

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Shoulder Anatomy

The structure of the shoulder joint, including the glenoid, labrum, rotator cuff, and ligaments that ensure maximal mobility while maintaining stability despite minimal bony structure

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Shoulder Dislocation

Displacement of the humeral head from the glenoid socket.

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Glenoid Socket

Part of the shoulder joint that holds the humeral head.

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Closed Reduction

Non-surgical method to relocate a dislocated joint (e.g., shoulder).

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Rotator Cuff Tear

Damage to the muscles and tendons around the shoulder joint.

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Physiotherapy

Treatment that uses exercises, massage, and other methods to restore movement and strength in the shoulder.

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Posterior Elbow Dislocation

Most common type, caused by forces on a flexed elbow.

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Anterior Elbow Dislocation

Elbow dislocation from a direct force to the posterior forearm.

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Nonoperative Treatment

Treatment for a dislocated joint without surgery.

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Closed Reduction

A procedure to relocate a dislocated joint without making an incision.

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Anterior Shoulder Dislocation

Most common shoulder dislocation, caused by a fall on the hand or excessive abduction-external rotation.

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Posterior Shoulder Dislocation

Rare shoulder dislocation caused by adduction and internal rotation forces, such as during convulsions.

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Kocher's Manipulation

A specific technique used in closed reduction of an anterior shoulder dislocation using abduction and rotation.

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Shoulder Dislocation (Clinical Picture)

Severe pain, arm held close to the body, shoulder looking squared, and emptiness below the acromion.

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Lunate Dislocation

Wrist dislocation, often needing an open reduction (incision), and can cause carpal tunnel syndrome.

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Open Reduction

Surgical procedure to relocate a dislocated joint using an incision.

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Shoulder Dislocation Treatment (Acute)

Closed reduction under anesthesia, followed by arm immobilization and exercises to prevent stiffness.

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Elbow Dislocation

Displacement of the elbow joint bones from their normal alignment.

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Posterior Elbow Dislocation

Most common elbow dislocation, usually caused by falling on an outstretched hand.

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Diagnosis (Elbow Dislocation)

Identifying a dislocated elbow, typically done through clinical examination and X-rays to confirm the injury's type and potential fractures.

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Closed Reduction (Elbow)

A non-surgical method to reposition the dislocated bones into their proper alignment.

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Post-Reduction Care (Elbow)

Treating the elbow after a dislocation, emphasizing support and range of motion in a plaster cast for 3 weeks, discouraging extreme movement or forceful stretching.

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Neurovascular injury (elbow)

Potential damage to nerves and blood vessels near the elbow, particularly the axillary nerve and artery.

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Elbow Stiffness

Reduced flexibility in the elbow joint, often a consequence of neglecting proper rehabilitation after dislocation.

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Mechanism of Injury (Posterior Elbow)

The way a fall on the outstretched hand causes a posterior elbow dislocation; causing disruption of ligaments and capsule.

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Study Notes

Joints Dislocation

  • Joints dislocation is a common injury, particularly the shoulder.
  • Pain is a primary symptom.
  • Shoulder anatomy relies on soft tissues for stability, not inherent bony structure.
  • The glenoid bone stock is limited.
  • The rotator cuff serves as a dynamic stabilizer.
  • The capsular and glenohumeral ligaments provide static stabilization.

Shoulder Dislocation Classification

  • TUBS: Traumatic aetiology, unidirectional instability, Bankart lesion (requires surgery).
  • AMBRI: Atraumatic (minor trauma), multidirectional instability, bilateral (asymptomatic shoulder is also loose). Rehab is treatment of choice.

Traumatic Dislocation Classification

  • Anterior: Common, involving glenoid labrum and capsule avulsion (Bankart lesion). Capsule is stretched anteriorly; indentation in the posterolateral humeral head.
  • Posterior: less frequent, a result of marked adduction-internal rotation.
  • Multidirectional: less frequent.

Causes of Shoulder Dislocation

  • Sports injuries (e.g., football, rugby, hockey, skiing).
  • Accidents.
  • Falling on shoulder or outstretched arm.
  • Seizures.
  • Electric shocks.

Risk Factors for Shoulder Dislocation

  • Previous dislocation (higher risk).
  • High-impact sports involving contact (throwing, falls).
  • Congenital conditions (such as Ehlers-Danlos Syndrome).
  • Weak shoulder and core muscles.
  • Incorrect posturePoor technique.

Signs and Symptoms of Shoulder Dislocation

  • Severe pain.
  • Swelling, bruising of shoulder or upper arm.
  • Numbness/weakness in arm, neck, hand, or fingers.
  • Trouble moving arm.
  • Feeling like arm is out of place.
  • Muscle spasms.
  • Palpable, prominent acromion (anterior bulge of humerus head).
  • Empty glenoid socket.
  • Shoulder is flattened.

Diagnosis (Shoulder Dislocation)

  • X-ray (anteroposterior and axial views).
  • MRI (to check rotator cuff, capsule, glenoid labrum).

Treatment (Shoulder Dislocation)

  • Nonoperative: Closed reduction under anesthesia, immobilization (4 weeks), NSAIDs, physiotherapy. Techniques include traction-countertraction, Hippocrates, Stimpson's, and Kocher's.
  • Surgical: For old/unreduced dislocation or recurrent dislocation.
  • Rehabilitation: Use of sling, massage, joint mobilization, ice/heat treatment, physical exercises (pendular movements), education/sport and daily activities, ergonometric postural correction, return to sport plan.

Dislocation of Elbow

  • Elbow dislocation (most common in young adults, excluding shoulder).
  • Elbow is a modified hinge joint with strong ligaments and good intrinsic stability.
  • Most frequent is posterior dislocation (often caused by a fall on an outstretched hand). A direct force to posterior forearm with elbow flexed is another common cause.
  • Diagnosis involves a clinical assessment, imaging (an X-ray).

Treatment of Elbow Dislocation

  • Urgent closed reduction under general anesthesia, gentle longitudinal traction with elbow flexed
  • immobilization.
  • Rehab after 3 weeks of immobilization, active exercises to avoid stiffness.

Dislocation of Wrist

  • Lunate dislocation (can cause carpal tunnel syndrome).
  • Usually requires open reduction, followed by rehabilitation to prevent hand stiffness.

Prevention

  • Take care to avoid falls.
  • Wear protective gear when in contact sports.
  • Regularly exercise to maintain strength and flexibility in your joints and muscles.

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