Shoulder Dislocation, posterior - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s academic animated video describes the condition of posterior shoulder dislocation.
The normal story is the that the patient checks out the emergency room and comes back to see the doctor since the client is having constant shoulder pain and is not able to move the shoulder.
When examining the patient, the client will have restriction of external rotation of the shoulder.
You may be revealed an x-ray, an AP view of the shoulder and the interpretation of the x-ray is that the shoulder appears regular. You need to get two x-ray views (orthogonal views); AP view and axillary view.
An AP view alone will not diagnose posterior shoulder dislocation. When you have a posterior dislocation of the shoulder, the AP x-ray view will show the classic “lightbulb” humeral head due to internal rotation of the shoulder. The humeral head takes on a rounded shape.
The axillary x-ray will show dislocation of the shoulder posteriorly. It is the very best view to show posterior shoulder dislocation. After reduction, always get an axillary view and check concentric decrease. Find the coracoid (anteriorly) and detail it. Locate the acromion (posteriorly). Locate the glenoid and figure out whether the dislocation is posterior or anterior.
In posterior dislocation of the shoulder, the axillary view will reveal the humeral head going posteriorly away from the coracoid and in the instructions of the acromion. With posterior shoulder dislocation, the shoulder is locked in the internal rotation position with prominence of the posterior shoulder, prominence of the coracoid process and flattening of the anterior shoulder.
Posterior shoulder dislocation might be related to fracture of the lesser tuberosity. 50% of posterior shoulder dislocations will have a reverse Hill-Sachs sore or impaction fracture beside the lesser tuberosity.
When you take a look at the client and you see restriction of the variety of motion, specifically external rotation of the shoulder, you might believe it is adhesive capsulitis (frozen shoulder). Frozen shoulder can start by limiting the external rotation; nevertheless it is generally an international limitation of the variety of motion.
Posterior dislocation of the shoulder is uncommon (about 5%) and it is typically stable after reduction if no fracture is present. Up to 50% of posterior dislocations of the shoulder can go underdiagnosed when the client is examined in the emergency space, specifically if dislocation results from seizures. If posterior dislocation of the shoulder happens due to seizures, the patient needs to be analyzed carefully, and a neurology speak with must be done to manage the patient’s seizures.
Treatment
Closed reduction
– Closed reduction is easy in the severe setting and can be done up to 3 months.
– Instability is rare with absence of fracture.
– Incapacitate the arm in neutral rotation with the elbow at the side and posterior to the plane of the body.
– Impaction less than 20%, do closed reduction and immobilize in external rotation.
Open decrease
– When posterior dislocation is chronic or locked.
– In locked posterior dislocation, the deltopectoral method to the shoulder is generally utilized.
Surgical treatment
– If the flaw in between 20-40% transpose the lower tuberosity or the subscapularis tendon into the problem.
– More than 45% flaw or if the dislocation is more than 6 months, do arthroplasty and place the prosthesis in less retroversion.

Follow me on twitter:
https://twitter.com/#!/ DrEbraheim_UTMC.

http://xraytechniciancertification.org/shoulder-dislocation-posterior-everything-you-need-to-know-dr-nabil-ebraheim/