Shoulder Dislocation
Shoulder Dislocation is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
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
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 December 7, 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 December 07]. 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
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