ANTERIOR DISLOCATION
Dislocation is usually caused by a fall on the hand.
The head of the humerus is driven forward, tearing
the capsule and producing avulsion of the glenoid
labrum (the Bankart lesion). Occasionally the posterolateral
part of the head is crushed
-Clinical features
Pain is severe
- The lateral outline of the shoulder may
be flattened and, if the patient is not too muscular, a
bulge may be felt just below the clavicle�A
-X-Ray
The anteroposterior x-ray will show the overlapping
shadows of the humeral head and glenoid fossa, with
the head usually lying below and medial to the socket
Treatment
In a patient who has had previous dislocations, simple
traction on the arm may be successful.
Stimson's technique, the patient is left prone
with the arm hanging over the side of the bed. After
15 or 20 minutes the shoulder may reduce.
In the Hippocratic method, gently increasing traction
is applied to the arm with the shoulder in slight
abduction, while an assistant applies firm countertraction
to the body (a towel slung around the
patient's chest, under the axilla, is helpful).
Complications
EARLY
-Rotator cuff tear
-Nerve injury
-Vascular injury
-Fracture-dislocationtear
LATE
Shoulder stiffness
-Unreduced dislocations
-Recurrent dislocations
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