Shoulder Dislocation

• What is the primary characteristic of the shoulder joint?

  The shoulder is a highly mobile joint that sacrifices stability for an increased range of movement.
• What is the incidence of shoulder dislocations in the general population?

  The incidence of shoulder dislocations is up to 1.7% in the general population.
• What percentage of major joint dislocations presented to emergency departments are shoulder dislocations?

  Shoulder dislocations account for over half of major joint dislocations presented to emergency departments.
• What can occur if shoulder dislocations are not managed correctly?


  If not managed correctly, shoulder dislocations can lead to chronic joint instability and chronic pain.
• What is the most common type of shoulder dislocation?

  The most common type of dislocation is anteroinferior, constituting around 95% of shoulder dislocations.
• What typically causes an anterior shoulder dislocation?

  An anterior dislocation is classically caused by force being applied to an extended, abducted, and externally rotated humerus.
• What are common causes of posterior shoulder dislocations?

  A posterior dislocation is typically caused by seizures or electrocution, but can also occur through trauma.
• What is a significant characteristic of posterior shoulder dislocations?

  Posterior dislocations are the most commonly missed dislocation of the shoulder.
• What are the clinical features of shoulder dislocations?

  All dislocations present with a painful shoulder, acutely reduced mobility, and a feeling of instability.
• What should be assessed in the arm following a shoulder dislocation?

  It is important to assess the neurovascular status of the arm, especially the axillary and suprascapular nerves.
• What are the commonly associated injuries with shoulder dislocations?

  • Bony injuries:
  • Bony Bankart lesions
  • Hill-Sachs defects
  • Fractures of the greater tuberosity and surgical neck of the humerus
  • Labral, ligamentous, and rotator cuff injuries:
  • (Soft) Bankart lesions
  • Glenohumeral ligament avulsion
  • Rotator cuff injuries
• What are Bony Bankart lesions?

  Bony Bankart lesions are fractures of the anterior inferior glenoid bone, most commonly present in those with recurrent dislocations.
• What are Hill-Sachs defects?

  Hill-Sachs defects are impaction injuries to the chondral surface of the posterior and superior portions of the humeral head.
• What percentage of traumatic dislocations present with Hill-Sachs defects?

  Hill-Sachs defects are present in approximately 80% of traumatic dislocations.
• What type of imaging is primarily used for shoulder dislocations?

  Plain radiographs are usually adequate in the acute setting for shoulder dislocations.
• What views are required in a trauma shoulder series for dislocation assessment?

  A trauma shoulder series requires at least 2 views: anterior-posterior and Y-scapular views.
• How can anterior dislocations be identified on radiographs?

  Anterior dislocations can usually be spotted on the anterior-posterior film as the humeral head is visibly out of the glenoid fossa.
• What does the 'light bulb sign' indicate in shoulder imaging?

  The 'light bulb sign' suggests posterior dislocation as the humerus is fixed in internal rotation.
• When is an MRI of the shoulder warranted?

  An MRI of the shoulder may be warranted if labral or rotator cuff injuries are suspected.
• What is the management protocol for shoulder dislocations?

  1. A to E trauma assessment
  2. Stabilise and examine for other injuries
  3. Provide appropriate analgesia
  4. Reduction, immobilisation, and rehabilitation
  5. Closed reduction by a trained specialist
  6. Assess neurovascular status pre- and post-reduction
  7. Place the arm in a broad-arm sling
  8. Physiotherapy to restore movement and strengthen muscles
• What is the typical length of immobilisation for an anterior shoulder dislocation?

  The typical length of immobilisation for an anterior dislocation is around 2 weeks.
• What are the potential complications following shoulder dislocation treatment?

  Potential complications include chronic pain, limited mobility, stiffness, and recurrence.
• What is a common complication of shoulder dislocations related to the rotator cuff?

  Rotator cuff injury is common and may require surgery.
• What degenerative condition can occur after labral and cartilaginous injuries from shoulder dislocations?

  Degenerative joint disease can occur, typically after labral and cartilaginous injuries and chronic recurrence.