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Joint Dislocations
Richard Hay
with minor assistance from James Wheeler
Shoulder Dislocations
Types of Dislocation
• Anterior - subcoracoid (60%)
Types of Dislocation
• Anterior - subcoracoid (60%)
• Anteroinferior - subglenoid (30%)
Types of Dislocation
• Anterior - subcoracoid (60%)
• Anteroinferior - subglenoid (30%)
• Posterior (4-10%)
Types of Dislocation
• Anterior - subcoracoid (60%)
• Anteroinferior - subglenoid (30%)
• Posterior (4-10%)
• Laxation ere...
Luxatio Erecta
inferior glenohumeral dislocation
Shoulder reduction techniques
General Principles
• Relocation prevented by
• Static forces
• Joint capsule / lip of glenoid
• Dynamic forces
• Rotator c...
General Principles
• Alignment
• Scapula and humeral head
• Zero position
• combination of external rotation and
abduction...
Reduction techniques
• No single best technique
• Hippocratic
• Kocher’s
• Matsen’s traction countertraction
• Milch
• Sti...
Hip Dislocation
Types of Dislocation
• Posterior (90%)
• Axial load in flexed adducted hip
• Position
• Flexion / adduction / internal rot...
• Case courtesy of Dr Sajoscha Sorrentino, Radiopaedia.org, rID: 14836
• Case courtesy of Dr Sajoscha Sorrentino, Radiopaedia.org, rID: 14836
Reduction
• Within 6hrs
• Patient supine
• Adequate sedation
• Posterior dislocation
• Stabilise pelvis
• Axial traction
•...
Ankle dislocations
Knee dislocation
• Use position of tibia as reference
• Anterior (most common)
• Hyperextension
• Posterior
• Force to ant...
Elbow dislocation
• 2nd most common large jt dislocation
• Simple / complex
• Radial head #
• Coronoid #
• Terrible triad
Knee dislocation
• High force injury
• Associated injuries
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
Joint dislocations
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Joint dislocations

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Joint dislocations

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Joint dislocations

  1. 1. Joint Dislocations Richard Hay with minor assistance from James Wheeler
  2. 2. Shoulder Dislocations
  3. 3. Types of Dislocation • Anterior - subcoracoid (60%)
  4. 4. Types of Dislocation • Anterior - subcoracoid (60%) • Anteroinferior - subglenoid (30%)
  5. 5. Types of Dislocation • Anterior - subcoracoid (60%) • Anteroinferior - subglenoid (30%) • Posterior (4-10%)
  6. 6. Types of Dislocation • Anterior - subcoracoid (60%) • Anteroinferior - subglenoid (30%) • Posterior (4-10%) • Laxation erecta - true inferior
  7. 7. Luxatio Erecta inferior glenohumeral dislocation
  8. 8. Shoulder reduction techniques
  9. 9. General Principles • Relocation prevented by • Static forces • Joint capsule / lip of glenoid • Dynamic forces • Rotator cuff • Biceps • Trapezius / deltoid • Pectoralis
  10. 10. General Principles • Alignment • Scapula and humeral head • Zero position • combination of external rotation and abduction • Relaxation
  11. 11. Reduction techniques • No single best technique • Hippocratic • Kocher’s • Matsen’s traction countertraction • Milch • Stimson’s • Scapular rotation • Cunningham • Spaso • Mane’s • Self rescue (Boss-Holzach-Matter)
  12. 12. Hip Dislocation
  13. 13. Types of Dislocation • Posterior (90%) • Axial load in flexed adducted hip • Position • Flexion / adduction / internal rotation • Anterior • Load on abducted externally rotated hip • Hip in extension - superior • XR - larger femoral head / lesser trochanter more visible • Hip in flexion - inferior • Position • Flexion / abduction / external rotation
  14. 14. • Case courtesy of Dr Sajoscha Sorrentino, Radiopaedia.org, rID: 14836
  15. 15. • Case courtesy of Dr Sajoscha Sorrentino, Radiopaedia.org, rID: 14836
  16. 16. Reduction • Within 6hrs • Patient supine • Adequate sedation • Posterior dislocation • Stabilise pelvis • Axial traction • Flex hip to 90 deg flexion, external rotation, extension and abduction • Anterior dislocation • Axial traction • Flex hip and knee to 90 deg, internal rotation, extension and adduction • CT post reduction
  17. 17. Ankle dislocations
  18. 18. Knee dislocation • Use position of tibia as reference • Anterior (most common) • Hyperextension • Posterior • Force to anterior tibia with knee flexed • Medial / lateral / rotational • Valgus / varus / rotational forces
  19. 19. Elbow dislocation • 2nd most common large jt dislocation • Simple / complex • Radial head # • Coronoid # • Terrible triad
  20. 20. Knee dislocation • High force injury • Associated injuries

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