The Dislocated Shoulder: Can You Ace This Orthopedic Oral Exam
What is the diagnosis for a left-hand dominant woman, aged 38, who fell on her right arm and went to the accident and emergency department the following day at 4 pm as the pain in her right shoulder had not subsided, shown by X-rays of her right shoulder (Figure 12.1a)?
Shoulder Dislocation and Greater Tuberosity Fracture Diagnosis and Management
1. Can you provide your diagnosis for this case presented?
2. How would you treat and manage this condition?
3. What are the risks and complications you anticipate?
4. What would you do if attempted closed reduction fails and the patient is in extended pain?
5. How will you perform the shoulder reduction?
6. Other than the described risk factors, what factors can also prevent closed stable reduction of the dislocation?
7. The X-ray of the right shoulder, one week later, displays no humeral neck fracture but significant greater tuberosity displacement. What is your management strategy?
8. Highlight the risks of non-operative management of displaced greater tuberosity fracture.
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Anterior shoulder dislocation - AP view
Humeral head and glenoid surfaces are not aligned The humeral head lies below the coracoid
Anterior shoulder dislocation - Y view
The humeral head lies anterior to the glenoid and inferior to the coracoid process
Anterior shoulder dislocation - Axial view
The humeral head surface is no longer aligned with the glenoid The humeral head lies anterior to the glenoid
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Anterior shoulder dislocation - AP view
Humeral head and glenoid surfaces are not aligned
The humeral head lies below the coracoid
Anterior shoulder dislocation - Y view
The humeral head lies anterior to the glenoid and inferior to the coracoid process
Anterior shoulder dislocation - Axial view
The humeral head surface is no longer aligned with the glenoid The humeral head lies anterior to the glenoid