What is your plan for Dislocation Management?
Ray Olivo sits down with Dr. Mundluru after his Dislocation Management presentation at the Memorial Hermann Sports Medicine Update.
Anterior Shoulder Disloaction
ALWAYS do a neurovascular assessment. Every single dislocation should experience this before reduction.
With the Shoulder there is a risk of axillary nerve entrapment
Typically if the nerves are intact distally then they are intact all the way up the nerve, therefore do your nerve tests at the distal end of the limb.
A dysvascular limb becomes a medical emergency so do a pulse check on both sides. double and triple check if there is no pulse as some are harder to palpate
Dr. Mundluru also recommends having the functional tests distal to check nerve and muscle function
- OK sign
- Thumbs up
- Cross fingers
- Scratch test
Repeat the scratch test at the deltoid and check bilaterally having the patient note any difference in sensation
A good motor assesment for dislocation management is having the patient press backwards at the elbow into the examiners hand. most other ROM tests will be limited or elicit pain.
They also discuss:
- Brachial Plexus Crush
- Transient symptoms after dislocation
- Sports Specific RTP
- When does it become surgical?
- Elbow Dislocations
- Hip Dislocations
- Patella and Knee
Whenever possible treat young patients non-operatively.
Have stories of Dislocation Management gone well or poorly?
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Ray Olivo – firstname.lastname@example.org
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Bob Marley – Bob.Marley@uth.tmc.edu
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