肩关节脱位复位.pdfVIP

Shoulder Dislocation Reduction 100 Techniques Katrina Skoog Nguyen, L. Connor Nickels, and Rohit Pravin Patel 100.1 Indications • More subtle presentation. Patient will maintain arm locked in internal rotation and adduction; he or she • Subjective history of new-onset dislocation or recurrent cannot externally rotate. Shoulder is fl attened ante- dislocations combined with clinical assessment consistent riorly and rounded posteriorly. with shoulder dislocation • Ultrasound can be used to prevent missed or delayed – Anterior dislocations (96 %) diagnosis (Figs. 100.1and 100.2show probe position- • Typical mechanism of injury being indirect, with ing and a diagram of abnormal ultrasound anatomy). combination of abduction, extension, and external – Inferior dislocations (luxation erecta) rotation. Rarely, the etiology is a direct blow to the • Arm will be held fi xed in overhead position. posterior shoulder. • Radiographs reveal shoulder dislocation. • Prominent acromion with a palpable drop off below • Ultrasound can be used to identify the nature of the dislo- the acromion and subclavicular region fullness is cation (anterior or posterior) and can be determined by consistent with anterior shoulder dislocation.