Shoulder and elbow emergencies

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Glenohumeral dislocations Key facts • Anterior shoulder dislocations are usually clinically obvious • Posterior shoulder dislocations can be difficult to identify • The shoulder is the most commonly dislocated joint in the body • 95% of shoulder dislocations will be anterior • Patients < 30 years of age have a high risk of recurrence Clinical presentation • The shoulder is the most commonly dislocated joint in the body • 95% of shoulder dislocations will be anterior • Patients have a squared-off appearance to the shoulder • The arm is held in slight abduction • Posterior dislocations can be difficult to detect by appearance alone • Patients often hold the arm adducted to the side • Seizures are classically associated with posterior dislocations • A thorough neurovascular exam of the affected extremity is essential to exclude a neurovascular injury • The axillary nerve is most commonly injured PEARL: Patients over the age of 40 should be evaluated for a possible rotator cuff tear, which may occur in greater than one-third of patients with glenohumeral dislocations. Diagnostic testing • Plain films of the shoulder are the test of choice • Perform an AP (Figure 2.1A) and a lateral projection (axillary lateral or scapular Y-view) (Figure 2.1B) PEARL: Failure to obtain a lateral projection can result in missing a posterior dislocation in up to 50% of cases.

Original languageEnglish (US)
Title of host publicationOrthopedic Emergencies
Subtitle of host publicationExpert Management for the Emergency Physician
PublisherCambridge University Press
Pages44-80
Number of pages37
Volume9781107696617
ISBN (Electronic)9781139199001
ISBN (Print)9781107696617
DOIs
StatePublished - Jan 1 2013

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Malik, S., Weiner, M., & Chiampas, G. (2013). Shoulder and elbow emergencies. In Orthopedic Emergencies: Expert Management for the Emergency Physician (Vol. 9781107696617, pp. 44-80). Cambridge University Press. https://doi.org/10.1017/CBO9781139199001.003