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The Problem

 A 60 yr old woman fell from the stairs


 Severe rt shoulder pain
 Patient supported Rt elbow joint with the Lft
hand
 O/E Rt shoulder showed loss of normal
rounded contour
 Attempt to move the shoulder joint was
painful
 A Diagnosis of Dislocation of Shoulder
joint was made
Bones taking part in the
formation of Shoulder Joint
 Scapula (Glenoid fossa)
 Humerus (Head)
Ligaments attached to the
Shoulder Joint
 Articular Capsule
 Glenohumeral Ligaments (3
supplemental bands)
 Coracohumeral Ligament
 Transverse humeral Ligament
 Glenoidal Labrum
Muscles of the Shoulder
Joint
 Supraspinatus
 Infraspinatus
 Teres minor
 Subscapularis
(multipennate)
 Teres major
 Deltoid
Movements of Shoulder
Joint
 Flexion and Extension
 Abduction and Adduction
 Medial and Lateral rotation
 Circumduction
Muscles producing the
Movements
Movements Main Accessory
muscles muscles
Flexion Clavicular part of
Pectoralis major
Coracobrachialis

Short head of biceps


Deltoid anterior fibres

Deltoid posterior fibres Teres major


Extension Latissimus dorsi Long head of triceps

Sternocostal head of
Pectoralis major (frm
flexion)
Muscles producing the
Movements
Movements Main muscles Accessory
muscles

Deltoid
Abduction Supraspinatus

Serratus anterior
Upper and lower fibres of
Trapezius

Adduction Pectoralismajor
Latissimus dorsi
Coracobrachialis

Teres major
Short head of biceps

Long head of triceps


Muscles producing the
Movements
Movements Main Accessory
muscles muscles

Medial Pectoralismajor
Deltoid anterior fibres
Subscapularis

rotation Latissimus dorsi

Teres major

Deltoid posterior fibres


Lateral Infraspinatus

rotation Teres minor


Dislocation of a Joint
 Also called Luxation, it occurs when
bones in a joint become displaced or
misaligned
 Often caused by sudden impact to
the joint
 Damage to Ligaments
The Commonest type of Dislocation of
the Shoulder joint is Inferior
Dislocation as the Joint is least
supported in the area
Results due to severe hyperabduction
of arm resulting in impingement of
humeral head against acromion

Humeral articular surface faces


inferiorly