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Outlines current management of upper limb conditions in primary care settings

This information is for primary care physicians and a general summary of current practice 

Please consult a physician directly for management of specific injuries  

Shoulder Dislocations

Overview of injury

Mechanism of Injury:  Anterior - Indirect external rotation + abduction force on arm (often seen in sports)

                                              Posterior - Posterior load on internally rotated arm (often seen in seizures or electrocution)

Associated injuries:    Bony Injuries - Bankhart + Hills-Sachs Lesion, GT fracture

                                              Soft Tissue - Anterior labral tear, disruption of glenohumeral ligaments, rotator cuff injury

  • Most common incidence of dislocation (up to 95%)

  • 20-30yo male/female ration 9:1 

  • 60-80yo female/male ratio 3:1

  • Subtypes - subcoracoid, subglenoid, subclavicluar

Anterior Dislocations

Posterior & inferior dislocations

  • Less common

  • Posterior 2-4%

  • Inferior <1%

Imaging

  • True AP - Dislocation/GT #/Bony Bankart

  • AP in IR - Hills-Sachs lesion

  • Lateral (Y-View) - Dislocation

  • Axillary lateral - Dislocation/Hills-Sachs lesion

Please refer patient to a ULQ fellowship trained hand surgeon for management 
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