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Shoulder fractures & dislocations.  Outstrech hand.

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Presentation on theme: "Shoulder fractures & dislocations.  Outstrech hand."— Presentation transcript:

1 Shoulder fractures & dislocations

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4  Outstrech hand

5  AP  30 degree cephalad view

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7  Injury to brachial plexus, great vessels, lungs  Malunion  Nonunion

8  Anterior (95-97%)  Subcoracoid (most common)  subglenoid (1/3 associated with # greater tuberosity, or # glenoid rim)  subclavicular  Posterior  Inferior and superior

9  Arm in abduction and external rotation. Force is taken on the hand or arm which increases the external rotation of the arm causing the head of the humerus to dislocate

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11  2-4% of shoulder dislocations  Secondary to seizure, direct blow to shoulder  Need to dx early to prevent long term complications

12 Adduction,int.rotation

13  AP may appear normal!  “light bulb” – int rotation of humeral head

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15  1)Counter traction traction  2)stimson

16  Mechanisms of Injury:  Fall on the tip of the unprotected shoulder.  Fall on the outstretched hand. 1)partial 2)complete

17  Grade I  Mild tenderness over AC joint, mild swelling  Full ROM  Grade II  Mod/severe pain, clavicle slightly displaced up  Grade III  Arm kept in adduction, obvious deformity

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19  Diagnose X-ray

20  Complete open reduction I and II Conservative (sling, ice, analgesia, physio) 6/52 before lifting III Conservative with late distal clavicle excision Refer to Ortho <72h

21  Rare  Most treated conservatively  Intraarticular displacement may need ORIF

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23  Conservative  OR

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25  Common anterior  Bankart leision  Hill-sachs leision  Apprehension test

26  Diagnose)CT SCAN Lat.Rotation abduction


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