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    Shoulder Dislocation

    Shoulder Dislocation is a topic covered in the 5-Minute Emergency Consult.

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    Emergency Central

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    Basics

    Description

    • Shoulder is a very dynamic joint, prone to injury.
    • Anterior dislocation (90–96%):
      • Injury is from direct or indirect forces on the abducted and externally rotated arm.
      • Injury may also result from a direct blow to posterolateral aspect of shoulder.
    • Posterior dislocation:
      • Often missed
      • Forces on the adducted and internally rotated arm result in posterior dislocation of humeral head in relation to glenoid fossa.
      • Most common mechanism is seizure and sudden contraction of all the posterior muscle groups.
      • Other mechanisms include electrocution and direct blow to anterior shoulder.
    • Inferior dislocation (rare):
      • Luxatio erecta
      • Hyperabduction of arm, tear of rotator cuff, and rotation of arm 180° above head
      • Commonly seen after a fall from a height:
        • Arm has struck object on descent and is thrust above the head.
      • Often accompanied by neurovascular injury and fracture

    Pediatric Considerations
    Dislocation is rare in children: Epiphyseal fractures must be suspected.


    Geriatric Considerations
    Dislocation is often accompanied by fracture.

    Etiology

    • Falls from height
    • Impact injuries
    • Distraction injuries of upper arm
    • Seizures
    • Electrocution

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    Citation

    Rosen, Peter, et al., editors. "Shoulder Dislocation." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307095/all/Shoulder_Dislocation.
    Shoulder Dislocation. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307095/all/Shoulder_Dislocation. Accessed April 24, 2019.
    Shoulder Dislocation. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307095/all/Shoulder_Dislocation
    Shoulder Dislocation [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307095/all/Shoulder_Dislocation.
    * Article titles in AMA citation format should be in sentence-case
    TY - ELEC T1 - Shoulder Dislocation ID - 307095 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307095/all/Shoulder_Dislocation PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -