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MSK > Common Dislocations > Flashcards

Common Dislocations Flashcards

1
Q

What is important in the history taking of dislocations?

A

TRAUMA: falls, RTA, sports injuries, seizures

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2
Q

What type of examination should be done in dislocations?

A

Inspection: deformity
Palpation: vascular supply, neurology - must be examined and documented before intervention

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3
Q

What is the common mechanism of injury that leads to a shoulder dislocation?

A

Fall with the shoulder in external rotation - anterior
Fall with the shoulder in internal rotation or direct blow to the shoulder - posterior
Arm held in abduction - inferior

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4
Q

How can a shoulder dislocate?

A

Anteiror - common
Posterior
Inferior - RARE

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5
Q

Who is likely to get a shoulder dislocation?

A

Common in young adults

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6
Q

What neurological assessment needs to be done in anterior dislocations?

A

Regimental badge area sensory assessment - axillary nerve

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7
Q

What neurological disorder are posterior dislocations associated with?

A

Seizure

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8
Q

What is the cardinal sign of a posterior dislocation on x-ray?

A

Light bulb sign

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9
Q

How is a shoulder dislocations managed?

A

Closed reduction under stabilisation
Open reduction
Stabilistaion and rehabilitation

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10
Q

What is the type of reduction method used in closed shoulder reductions?

A

Hippocratic, in-line traction

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11
Q

What directions can an elbow dislocate?

A

Posterior
Anterior
Divergent
Medial/ lateral

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12
Q

What are the associated fracture risks with elbow dislocations?

A

Radial head or coronoid process

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13
Q

What structures are at risk with an elbow dislocation?

A

Anteriorly: brachial artery and median nerve
Posteriorly: radial nerve

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14
Q

How can neurovascular status be assessed in children?

A

Make an OK sign: median nerve
Point - motor of radial
Starfish - ulnar

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15
Q

How can an elbow dislocation be managed?

A

Closed reduction under sedation
Open reduction is rarely needed
2 weeks in a sling and rehab

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16
Q

What are the different reduction methods utilised in elbow dislocations?

A

Traction in extension +/- pressure over the olecranon

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17
Q

What is the mechanism of injury of an IPJ?

A

Hyperextension with a direct axial blow

18
Q

What way with an IPJ dislocate?

A

Almost always posterior

19
Q

What complications can occur with IPJ dislocations?

A

Head of phalanx button-holes through volar plate

Recurrent instability due to associated fracture

20
Q

What is the management for an IPJ dislocation?

A

Closed recution under digital or metacarpal block
2 weeks in neighbour strapping
Volar slab in edinburgh position if unstable

21
Q

What reduction methods are used for IPJ dislocations?

A

In line traction with corrective pressure

22
Q

What is the mechanism for patellar dislocation?

A

Sudden quads contraction with a flexing knee

23
Q

How will the patella dislocate?

A

Always laterallly

24
Q

Who is likely to get a patellar dislocation?

A

Most common in teenage girls

25
Q

What can cause patellar dislocations?

A

Hypermobility
Under-developed lateral femoral condyle
Increased Q angle (genu valgum, increased femoral neck anteversion)
Lateral quads insertions or weak vastus medialis

26
Q

What is the Q angle?

A

Line from ASIS to midpoint of patella

Second line from tibial tubercle to midpoint of patella

27
Q

How will a patellar dislocation present?

A

Clear history of patella dislocating laterally

Self-relocating

28
Q

What will a patellar dislocation show upon examination?

A

Pain medially from a torn medial retinaculum
Haemarthrosis
Patellla apprehension test

29
Q

How are patellar dislocations managed?

A 
Reduce with knee extension 
Radiographs 
Aspiration 
Brace
PT
30
Q

What surgery can be performed for recurrent dislocations?

A

Lateral release
Patella tendon realignment
Reconstruction of MPFL with a graft

31
Q

Why should a spontaneous knee relocation not be missed?

A

LCL injury

Fibular nerve injury

32
Q

What type of knee dislocation can injure the popliteal artery?

A

Posterior dislocation

33
Q

What shouldy you do if you suspect a vascular injury in a knee dislocation?

A

Arteriogram/ MRI

34
Q

How is a knee dislocation managed?

A

Reduction under sedation

May require theatre reduction if condyle button holed through the capsule

35
Q

What are the complications of a knee dislocations?

A

Arthrofibrosis and stiffness
Ligament laxity
Nerve or arterial injury

36
Q

What are the common mechanisms of hip dislocations?

A

High velocity: RTA dashboard injury, fall from height

37
Q

What direction will hips commonly dislocate?

A

Posteriorly

38
Q

What are the associated fractures that can occur with a hip dislocation?

A

Posterior acetabular wall

Femoral

39
Q

How will a dislocated knee present?

A

Flexed, internally rotated and adducted

40
Q

How is a dislocated hip managed?

A 
Neurovascular assessment (esp. sciatic nerve) 
Radiographs 
Urgent reduction 
Stabilise in tractions if required
CT
41
Q

What are the complications of hip dislocations?

A

Sciatic nerve palsy
AVN of the femoral head
Secondary OA

MSK (34 decks)

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