ORTHOPAEDICS - ADULT

ResponseSeem to have a lot of terms for it:
Anterior dislocation of right humeral head, Inferior dislocation of right humeral head
Humeral head dislocation inferior and medial to “normal position”
“Infraglenoid” shoulder dislocation
Superior cortical irregularity suggests Hill-Sachs fracture (Hill sachs = Humerus)
No clear labral irregularity to suggest bancart lesion
GT displaced laterally

ResponseClinical - Hymeral head sub-coracoid and palpable in the deltopectoral view
Radiographically - Scapular Y or axillary view and humeral head anterior to glenoid

ResponseKochers: Arm flexed and abducted, gentle traction, external rotation until resistance, then extend to sagittal plane, then internal rotation to opposite shoulder
Spaso: Extend arm in sagittal plane, gentle traction, external +/- internal rotation
Scapular manipulation: patient sitting/prone with arm extended and gentle traction, move tip of scapular medially/towards spine
Milch: abduction and external rotation to overhead position with fixation of head of humerus
Stimson : Patient prone with gentle traction/weight to arm
Cunninghams: Support patients arm flexed 90 degrees and adducted. Gentle traction with massage of traps/deltoid/biceps sequentially
Hippocrates: Gentle sustained traction of abducted and flexed arm with countertraction with sheet (Traction-countertraction)
MUST be able to describe at least one of these - I have bolded 3 random ones so I remember the same ones

ResponseFrozen shoulder
Axillary nerve damage - Deltoid + teres minor - reduced abduction + external rotation
Cuff injury./tear
Ongoing instability/re-dislocation
Other soft tissue injury (Glenoid tear)
Axiallary artery injury - Rare

Impingement of GT against acromion (GT # in stem)

ResponseRemain in shoulder immobiliser at all times unless showering
At no time abduct or externally rotate shoulder (+ demonstrate)
Attend follow up
Simple analgesia
Return if recurrence