DISLOCATION OF MAJOR JOINT DKJFBSDKJF.pptx

DISLOCATION OF MAJOR JOINTS

1. DISLOCATION OF MAJOR JOINT DR. N M SHIRSAT PROFFESOR ORTHO DUPMC JALGAON JOINTS : WHEN TWO ARTICULATING BONES ARE HELD BY LIGAMENT AND SURROUNDING MUSCLE IN PARTICULAR POSITION IS KNOWN AS JOINTS. >STATIC STABILIZER ---LIGAMENTS > DYNAMIC STABILIZER ---MUSCLES DISLOCATION – A JOINT IS DISLOCATED WHEN ITS ARTICULAR SURFACE ARE COMPLETELY DISPLACE ONE FROM THE OTHER SURFACE SO THAT ALL CONTACT BETWEEN THEM IS LOST.

2. SUBLUXATION A JOINT IS SUBLUXATED WHEN ITS ARTICULAR SURFACE ARE ONLY PARTLY DISPLACED AND RETAIN SOME CONTACT BETWEEN THEM.

3. FIG 1.4 DISLOCATION AND SUBLUXATIION OF JOINTS

4. CLASSIFICATION:- A) CONGENITAL >>>>>> CDH B.) TRAUMATIC >>>>>> ACUTE >>>>>>OLD UNREDUCED >>>>>>>RECURRERENT >>>>>>> FRACTURE DISLOCATION C.) PATHOLOGICAL >>>>>>> INFECTION >>>>>>> NEOPLASTIC >>>>>>>LIGAMENT DAMAGE DUE TO DISEASE/DEGENERATION

5. PATHOANATOMY DISLOCATION CANNOT OCCURES WITHOUT DAMAGE TO THE PROTECTIVE LIGAMENT OR JOINT CAPSULE FIG 8.1 PATHOANATOMY OF DISLOCATION

6. DIAGNOSIS :- 1. PAIN 2 .SWELLING 3 .RESTRICTION OF MOVEMENTS 4.SHORTENING OF LIMBS 5. DEFORMITY

7. RADIOLOGICAL EXAMINATION X RAY CT SCAN

8. COMPLICATIONS A) IMMEDIATE  NEUROVASCULAR INJURY B) EARLY  RECURRANCE  MYOSITIS OSSIFICANS  PERSISTENT INSTABILITY LATE  JOINT STIFFNESS  OSTEOARTHRITIS  AVASCULAR NECROSIS

9. TREATMENT 1) CONSERVATIVE- -----> CLOSED REDUCTION (ACUTE CASES) 2) SURGERY -------------> FAILURE OF CLOSED REDUCTION FRACTURE DISLOCATION OLD UNREDUCED DISLOCATIION RECURRENT DISLOCATION

10. A) SHOULDER JOINT A ) SHOULDER INSTABILITY  UNIDIRECTIONAL ( IN ONE DIRECTION) BIDIRECTIONAL MULTIDIRECTIONAL B ) SHOULDER DISLOCATION  1. ANTERIOR 2. POSTERIOR 3. INFERIOR

11. TYPES A.ANTERIOR DISLOCATION

12. PATHOLOGICAL CHANGES ARE MORE COMMON IN ANTERIOR SHOULDER DISLOCATION

13. BANKART’S LESION HILL SACH’S LESION ROUNDING OFF OF GLENOID RIM ASSOCIATED INJURIES  FRACTURE GREATER TUBEROSITY ROTATOR CUFF TEAR CHONDRAL DAMAGE

14. B)POSTERIOR DISLOCATION  LIGHT BULB SIGN SEEN ON X-RAY

15. C) LUXATIO ERECTA (INFERIOR DISLOCATION) THIS IS RARE TYPE WHERE THE HEAD COMES TO NLIE IN THE SUBGLENOID POSITION

16. ELBOW DISLOCATION TYPES  A.POSTERIOR B.POSTERIO MEDIAL C.POSTERO LATERAL D DIVERGENT –RADIUS DISPLACED LATERALLY AND ULNA

17. HIP JOINT :TYPES  A. POSTERIOR DISLOCATION B.ANTERIOR DISLOCATION C.CENTRAL FRACTURE DISLOCATION

18. WRIST DISLOCATION -RARE TYPES :- A. LUNATE DISLOCATION - LUNATE DISLOCATION ANTERIORLY BUT THE REST OF CARPALS REAMIN IN POSITION. B. PERILUNATE DISLOCATION -LUNATE REMAINS IN POSITION AND THE REST OF CARPALS BONES DISLOCATE DORSALLY.

19. PATELLA DISLOCATION THE PATELLA USUALLY DISLOCATE LATERALLY. > TYPES:- a) ACUTE b) RECURRENT c) HABITUAL

20. FRACTURE DISLOCATION MONTEGIA FRACTURE DISLOCATION TYPES:- EXTENSION FLEXION  FRACTURE OF UPPER THIRD OF ULNA WITH DISLOCATION OF HEAD OF RADIUS.

21. GALEAZZI FRACTURE DISLOCATION  FRACTURE OF LOWER THIRD OF RADIUS WITH DISLOCATION OF SUBLUXATION OF DISTAL RADIO ULNAR JOINT.

22. BENNETT’S FRACTURE DISLOCATION  IT IS AN OBLIQUE INTRAARTICULAR FRACTURE OF THE BASE OF FIRST METACARPAL WITH SUBLUXATION OR DISLOCATION OF THE METACARPAL.