The test for whether a shoulder has relocated or not is to ask the patient
to put the hand of the affected shoulder on the other one. If it is
dislocated in any plane they will be unable to do this. The post reduction
film is really only to reassure yourself you haven't done any more damage. I
remember one old lady who seemed in a lot of pain while I was reducing a
fracture dislocation years ago. When I got the film I hadn't reduced it at
all - I had torn her humerus in half at the fracture line through the
surgical neck.
Best wishes
Rowley.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Paul Bailey
Sent: 20 January 2006 13:03
To: [log in to unmask]
Subject: Re: Post reduction x-rays for anterior shoulder dislocation
I think mostly the post reduction x-rays are performed to assess for
complications of the reduction and the original injury eg #'s.
There is no need for x-ray to confirm that the joint is actually relocated -
you just ask the patient when they wake up (or if you haven't sedated them
ask them any time!). If it's not painful and you can move it, chances are
it's in the right place.
Interestingly, last year I saw for the first time an unstable posterior
shoulder dislocation that was easily reduced, but fell out again except when
we held it in external rotation.
How many of you routinely get pre-reduction x-rays?
Paul Bailey
Western Australia
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of [log in to unmask]
Sent: Friday, 20 January 2006 8:28 PM
To: [log in to unmask]
Subject: Post reduction x-rays for anterior shoulder dislocation
Dear All,
How many views do you all perform post reduction of a Anterior inferior
dislocation of a shoulder.
Do you all perform two views AP & an axial or Y view to make sure the
shoulder has been properly reduced?
Certainly it is good science but can be difficult to perform soon after
reduction.
I would appreciate your views
Salim Shubber
Eastbourne
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