True statement regarding posterior dislocation of shoulder joint
(Internal rotation) (75-M)* Anterior dislocation is much more common than posteriorPosterior dislocation of Schoulder is rare.Mechanism of injury - Indirect force producing marked internal rotation* and adduction* must needs be very sever to cause a dislocation. This happens most commonly during a fit or convulsions or with electric shock.ANTERIOR SHOULDER DISLOCATIONPOSTERIOR SHOULDER DISLOCATION* Due to shallowness of the glenoid socket, the extra ordinary range of the movement, ligamentous laxity or glenoid dysplasia* The lateral out line of the shoulder may be flattened, bulge may be felt just below the clavicle* The front of the shoulder looks flat with a prominent coracoid* Posterior displacement is usually apparent* The characteristic physical sign is loss of lateral rotation of the shoulder which is locked in medial rotation (Watson & Jones)* Posterior dislocations are often difficult to diagnose because the patient may have a normal contour to the shoulder or the deltoid of a well developed athlete may mask signs of a displaced humeral head (207-current diagnosis & treatment 4th)* A "reverse Hill- Sachs lesion" may appear on the anterior articular surface of the humerusPatho physiological changes* Bankart s lesion - Dislocation causes stripping of the glenoidal labrum along with the periosteum from the anterior surface of the glenoid and scapular neck**** Hill- Sach s lesion - is a depression on the humeral head in its postero-lateral quadrant.* Ebumated rim of the glenoid* Associated of the GT of the humerus or rim of the glenoid* Dugas' test, Hamilton ruler test, callway's test are positive in Anterior dislocation of the shoulder joint* Axillary nerve and Axillary artery injury is common in Anterior dislocation of the shoulder jointEmpty glenoid sign - in AP- film the humeral head because it is medially rotated, looked abnormal in shape (like an electric light bulb) and it stands away somewhat from glenoid fossa is seen in posterior dislocation of the shoulder joint* Patella almost always dislocates laterally* Recurrent dislocations are extremely rare in the Ankle joints*Recurrent dislocations of schoulder jointsThree important lesions1. Hill sach's lesions**2. Bankart's lesion**3. Erosion of anterior rim of glenoid cavityOther pathologic lesions1. Capsular laxity*2. Sub capsular's deficiency3. Glenoid fossa deficiency Anterior cruciate ligamentPosterior cruciate ligament* Prevent anterior translation of the tibia on the femur**.limits hyper extension** Attached on tibia just behind anterior horn of medial meniscusRuns upwards back wards and laterally* Attached on femur- over medial surface of lateral femoral condyle* It is intracapsular and intrasynovial** It is tout during extension of knee* Prevent posterior translation on tibia on the femur*** Attached on tibia behind posterior horn of medial meniscusRuns upwards forwards and medially* Attached on femur over lateral surface of medial femoral condyle* It is intracapsular but extrasynovial** It is tout during flexion of knee*
External rotation
Internal rotation
Axillary nerve palsy
Anterior hollowness
Injuries Around Shoulder