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Gen Ortho- Dislocations + Sublux

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taylormaloney's version from 2016-12-04 06:56

Section 1

Question Answer
Define DislocationThe complete dissociation of articulating surfaces.
Define SubluxationWhen the articulating surfaces remain in partial contact with one another
What is the most frequently dislocated joint? Why?GH, because only a small portion of the humeral head comes into contact with the glenoid fossa. Relies largely on ligaments/muscles.
What other joints are considered prone to dislocation?AC Joint, MCP + IP Joints.
What joints are considered relatively stable? Much more secure?Ankle, Knee, Elbow, TMJ. Much more secure = AF joint of hip.
In the case of dislocation, what damage takes place on surrounding ligaments/joint capsule?Completely torn, or partially ruptured. W/ partial damage to tendons, synovial sheaths, articular cartilage, and soft tissues.
In the case of subluxation, what damage takes place on surrounding structures?Joint capsule is stretched, possible joint sprains.
What is the mechanism of action that would cause a dislocation or subluxation?Trauma, with a sudden twist or wrench of joint beyond it's normal range.
What are the two classifications of Trauma regarding dis/subluxations?Direct- Direct force on joint itself. Or Indirect- joint becomes weak link in kinetic chain. (FOOSH)
What are some possible contributing factors?Pathologies such as RA, paralysis, neuromuscular diseases, or previous dis/subluxations.
What are the medical treatment options?Tractioning- bringing the surfaces back into contact with each other. (Joint reduction). Surgery- intentional shortening of joint capsule, intentional limitation of ROM.
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Section 2

Question Answer
GH dislocation- most common form of injury?Anterior dislocation, caused by excessive abd and ext rot. (FOOSH)
GH dislocation- causes head of humerus to go in which direction?Through inf portion of joint capsule, lodging inferior to coracoid process.
GH dislocation- potential damage to what structures? Ant portion of glenoid labrum, axillary nerve.
GH dislocation- potential treatment?Reduction,held stable in internal rotation with sling. Possible Putti Platt surgery(shortening of suprascap).
Patellar Dislocation- most common form of injury?Lateral dislocation, caused by ext rot of tibia and foot when knee is flexed.
Patellar Dislocation- possible treatment?After multiple incidences, surgical relocation of tibial insertion of Quads moved to more medial location.
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Section 3

Question Answer
What is the difference between an Open and Closed reduction?Open- fracture fragments exposed surgically by tissue dissection. Closed- fracture fragments manipulated without surgery.
Lunate Dislocation- possible cause of injury?FOOSH forcing wrist into hyperextension- radius forces lunate in palmar direction which lodges lunate anteriorly.
How would lunate dislocation be placed during healing? Possible Complications?Reduction then immobilization in flexion for month. Medial nerve lesions and necrosis of lunate.
Elbow dislocation- probable causes? Most likely accompanied by?FOOSH/MVA- fracture.
Elbow dislocation- direction of dislocation and possible complications?Ulna + Radius displaced posteriorly. Possible lesions to brachial artery, ulnar and median nerves. Myositis Ossificans.
Hip Dislocations- possible cause of injury? Direction of displacement?MVA- likely femur displaced posteriorly due to impact to the knee.
Hip Dislocation- potential complications? Length of limb tractioning?Fracture to rim of acetabulum, compression of sciatic nerve. 6 weeks tractioned.
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Section 4

Question Answer
Acute Symptoms Joint Dis/SubluxationsComplete/Partial rupture to capsule, snapping sound, intense pain, deformed appearance, local edema/heat, joint effusion, possible hemarthrosis, instability, black/blue bruising, v ROM, protective mm spasms, cannot continue activity.
Possible complications of Acute Dis/Subluxation?Strains, contusions, blood vessel and nerve injury, fractures, hematoma,
Early Subacute-Joint unstable, black/blue bruising, hematoma still present, pain/edema/inflammation present but reduced, adhesions developing, v protective spasms, TPs, mms only stability, v ROM.
Late Subacute- Yellow/Green/Brown bruising, pain/edema/inflammation diminishing, adhesions maturing, protective mm spasms replaced by HT in muscles, joint is supported/immobilized, potential antalgic gait.
Chronic- Pain to joint capsule when stretched, no bruising, adhesions matured, HT + TPs, restricted ROM, tissue cool from ischemia, instability in direction of injury, mm weakness/atrophy, loss of joint proprioception.
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