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Shoulder Dislocation Essay

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Recurrent shoulder dislocation in the elderly – what should the ED management be?
Abstract
Shoulder dislocation is a common medical condition seen in the A&E Department. It is usually a result of trauma or is associated with ligamentous laxity in spontaneous cases. Its occurrence in the elderly population is less common and as the elderly usually has multiple medical co-morbidities including osteoporosis, treatment with manipulation and reduction of a shoulder dislocation in the elderly has to be attempted with extreme care due to potential complications. We report a case of an elderly Chinese lady with a history of recurrent right shoulder dislocation presenting to the A&E department with an atraumatic right shoulder dislocation who underwent a closed reduction of the dislocated right shoulder in the A&E but unfortunately had a complication - fracture of the proximal neck of humerus. This article …show more content…
However, most young and middle-aged patients with shoulder dislocations are male, whereas most of the elderly patients are female.. In addition, many of these injuries are not isolated injuries and there are significant problems that arise distinctly in the older population. Some of these include rotator cuff injury, brachial plexus injury and axillary artery injury4. The prevalence of recurrent shoulder dislocation is around 40% for adolescents and young adults whereas various studies on patients over 40 years have quoted prevalence up to 22% in elderly patients1. Nevertheless, the recurrence in older patients may reflect a more significant injury with potential need for imaging and reconstructive surgery. Kinnett et al identified 3 risk factors for recurrence of dislocations in the elderly – increased ligamentous laxity, increased activity level and high-energy

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