Recurrent Closed Anterior Dislocation Of

Glenohumeral Joint

Hasanuddin University Hospital

Presented By :

Fyco Christian K

Advisor :

dr. Felix S. Batuna

dr. Aries Hutabarat

Supervisor :

dr. M. Ruksal Saleh, Ph.D, Sp. OT

Orthopaedic and Traumatology Department

Medical Faculty of Hasanuddin University

Makassar

2015

CASE PRESENTATION

May 2015

Patient Identity

Name : Mr. PA

Age : 65 y.o.

Gender : Male

Admission Date : May 10th, 2015

Registration : 711437

History Taking

Chief Complain :•Pain on the left shoulderAnamnesis :•Suffered since 1 hour before admitted to the hospital due to traffic accident, felt continuously and worsening when moving the armMechanism of Trauma :•Patient sit at 2nd row and a passenger. The car hit a tree and bump his left shoulder to the front seat. After that, he felt pain and can not move his left armHistory of Past Disease :•Underwent surgery 4 months ago due to dislocation of the left shoulder for 6 months ago

Primary Survey

Airway : ClearBreathing : RR 24 x/min, spontaneous,

thoracoabdominal typeCirculation : HR 98 x/min, strong, regular, BP 130/70Disability : GCS 15 (E4M6V5), pupil isochoric

ɸ 3mm/ 3mm, light reflex +/+Exposure : T (axilla) 36.5 oC

Seconday Survey

Left Shoulder Region•Look : Deformity (+), Flat Shoulder (+),

hematome (-), Swelling (-), Scar (+)•Feel : Tenderness (+)•Move : Active and passive motions of shoulder

joint can not be evaluated due to pain•NVD : Sensibility is good, pulsation of radial

artery is palpable, CRT < 2 seconds

Physical Findings

Anterior View

Physical Findings

Posterior View Lateral View

Laboratory Findings

• WBC : 10.000/ ul• RBC : 4.070.000/ ul• HBG : 12,9 g/dl• HCT : 36 %• PLT : 275.000/ ul• CT : 3’00’’• BT : 6’00’’• HBsAg : non-reactive

Radiological Findings

Radiological Findings

Discussion

Evidence Leading to Diagnosis

• History Taking

• Physical Examination

• Radiological Examination

• Radiological Examination

Diagnosis

Recurrent Closed Anterior Dislocation of The Left Glenohumeral Joint

Treatment

• IVFD RL• Analgetic• Closed Reduction• Apply Velpeau Bandage

Complication

Early•Ligament injury•Neurological injury•Vascular injury •FractureLate•Joint stiffness•Recurrent dislocation

Thank you for your attention!