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Always examine and document axillary nerve function
BONE | INJURY SITE | TYPICAL MECHANISM | PITFALLS COMPLICATIONS | ED/ MIU/ UCC TREATMENT | FOLLOW UP | |
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Dislocated shoulder | Anterior | Fall onto shoulder Wrenching injury | Axillary nerve injury Humeral # may occur during reduction if rotation used. Rotator cuff tear especially in older patients | Reduce under sedation: Axial traction only with Senior input. Document neurovascular exam/ sensation in regimental badge area at each stage | X-ray in 2 planes post reduction Refer if unable to reduce Successful reduction - Fracture clinic, sling | |
Dislocated shoulder | Posterior | Direct blow, convulsion electric shock | Easily missed without 2 orthogonal views on X-ray. Look for 'light bulb' sign. Neurovascular injury | Reduce under sedation using axial traction only. Document neurology exam at each stage | As for anterior dislocation: Sling and Fracture clinic |