Anterior shoulder-dislocation
- 2. C 犖犖項犖犢犖о権犖犖犖巌犢犖犖 犖犖迦権犖 78 犖犖 犖犖項検犖巌献犖迦犖犖 犖犖迦犖犖犖犖朽犖巌犖 犖犖園犖犖о険犖犖犖犖犖犖迦犖犖朽検犖 PATIENT PROFILE
- 3. C犖∇犢犖犖犖犖о顕犢犖÷犢犖犢 6 犖犖園犖о犖÷ CHIEF COMPLAINT
- 4. C 6 犖犖園犖о犖÷犖犢犖犖犖÷顕犢犖犖犖犖∇顕犖犖迦献 犖犖項犖犢犖о権犢犖犖巌犖犖萎犖伍犖犖犖犖犢犖迦献犢犖 犢犖犖迦犖犖ム犖犖о顕犖犖犖萎犖犖犖犖劇犖 犖犖朽牽犖犖萎犖÷犖犖犖萎犖犖犖犖劇犖 犖犖ム険犖犖犖迦 犖犖園犖犖犖о犢犖犖ム犖犖о顕 犢犖÷犖÷元犖犖迦犢犖犖 犢犖÷犖÷元犖犖 犖∇犢犖犖犖犖о顕犢犖÷犢犖犢 犖犖謹犖÷顕犢犖犖犖犖∇顕犖犖迦献 PRESENT ILLNESS
- 5. C *犢犖犢犖犢犖犖犖犖ム賢犖犢犖ム厳犖犖犖犖園硯犢犖犖犖朽 犢犖犖∇犢犖迦犖園犖犖 BALLOON 犢犖 6 犖犖朽犢犖犖 (犖÷元犖∇顕犖ム鍵犖ム顕犖∇献犖巌犖÷犖ム厳犖犖犖犖巌犖犖∇弦犢) *犢犖÷犖÷元犖犖犖萎硯犖園犖巌犖犢犖∇顕犢犖犢犖犖迦見犖迦牽 *犢犖÷犢犖犖∇犖犢犖犖園犢犖ム厳犖犖 *犢犖÷犢犖犖∇犖犖ム犖犖ム幻犖犖÷顕犖犢犖犖 *犢犖÷犖犖劇犖÷肩犖伍牽犖 犢犖÷犖犖項犖犖伍見犖犖朽 PAST HISTORY
- 6. C PHYSICAL EXAMINATION A can talk , c-spine not tender B equal breath sound , no use accessory muscle , CCT -ve C alert ,BP 128/75 mmHg PR 98/min full , PCT -ve D E4V5M6 , pupil 3 mm RTLBE
- 7. C PHYSICAL EXAMINATION Mild tender , no swelling Limit ROM No loss of sensation Deltoid can contract Elbow and wrist can move not tender at another area Dugas test + Rulers test + Palpable head of humerous
- 8. C FILM
- 9. C DIAGNOSIS Left Anterior shoulder dislocation
- 10. C MANAGEMENT Morphine 4 mg IV stat Valium 10 mg IV stat Start reduction! >> Close reduction
- 13. C
- 14. C
- 16. Glenohumeral joint SHOULDER -Bone : Humerus , scapula , clavicle -Ball & socket joint -labrum is piece of cartilage (between head of humerus and glenoid)
- 17. SHOULDER -Rotator cuff muscle : supraspinatus muscle infraspinatus muscle subscapularis muscle teres minor muscle -Ligaments that help : coracohumeral ligament glenohumeral ligament
- 18. SHOULDER -Rotator cuff muscle : supraspinatus muscle infraspinatus muscle subscapularis muscle teres minor muscle -Ligaments that help : coracohumeral ligament glenohumeral ligament
- 19. ANTERIOR SHOULDER DISLOCATION Mechanism : - direct blow from posterior aspect of shoulder - abduction + external rotation + extension injury - tear ligament around shoulder - Axillary nerve injury
- 20. Clinical feature -Pain -arm position : abduction & external rotation -adduction is restricted -lost of normal shoulder contour Dugas test + Rulers test + Palpable head of humerous
- 21. Imaging AP view Transcapular view
- 22. Imaging AP view Transcapular view
- 23. Treatment >> most CLOSE REDUCTION (under GA) -Hippocrates method
- 24. Treatment >> most CLOSE REDUCTION (under GA) -Hippocrates method -Zero position
- 25. Treatment >> most CLOSE REDUCTION (under GA) -Hippocrates method -Zero position -Traction - countertraction
- 26. Treatment >> most CLOSE REDUCTION (under GA) -Hippocrates method -Zero position -Traction countertraction *after reduction -on interlocking sling 3 weeks -if age > 45 years .. On interlocking sling 1 week and early ROM exercise