Shoulder Dislocation

• April 22, 2023
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Shoulder dislocation occurs when the upper arm bone (humerus) pops out of the shoulder blade (glenoid). It can happen due to a fall or a blow to the shoulder or even during a sports activity. The shoulder joint is one of the easy joints to dislocate as the ball joint of our upper arm is placed in a very shallow socket, making arms very flexible and able to move in any direction also means it is not very stable. In many cases, the surrounding tissues supporting the shoulder joint may also be overstretched or torn. A dislocated shoulder takes up to 16 weeks to heal after the shoulder has been put back into place. The dislocated shoulder can be painful and may require immediate medical attention.

Causes:

- Traumatic injury from falls, collisions, or sports accidents

- Overuse or repetitive strain from activities such as throwing or swimming

- Abnormal shoulder anatomy or instability

Symptoms:

- Severe pain in the shoulder

- Swelling and bruising around the shoulder

- Limited range of motion and weakness in the shoulder

- A visibly deformed or dislocated shoulder joint

- Numbness of the arm.

Radiograph is used to confirm the diagnosis, with most dislocations visible, showing all incongruent glenohumeral joints. While posterior dislocations are difficult to detect on standard anterior-posterior (AP) radiographs, other tests can help identify them. After reduction, healthcare providers usually take additional radiographs to confirm and check for any bone damage.

MRI scan is applied to assess soft tissue damage in those people who have suffered repeated shoulder dislocations. There are three main types of dislocations: anterior, posterior, and inferior. Anterior dislocations are determined using the apprehension and sulcus test for inferior dislocation. In over 95% of shoulder dislocations, the humerus is Anteriorly displaced. An outstretched arm receiving a direct blow to it or falling on it frequently results in anterior dislocations.

Posterior dislocations are usually uncommon and often occur typically due to muscle contraction from electric shock or seizure. Inferior dislocation has less than a 1% chance of occurring. Hyper abduction of the arm that forces the humeral head against the acromion is the leading cause of inferior dislocation. Such injuries have a high complication rate as many vascular, neurological, tendon, and ligament injuries are likely to occur from this mechanism of injury.

Dislocated shoulder treatment might involve:

• Closed reduction- In reduction therapy, some techniques are applied to move the shoulder bones back into position, which means putting the upper arm bone back into the shoulder blade socket. A sedative might be given before moving the shoulder bones, depending on the intensity of pain and swelling. After the shoulder bones are moved back into place, severe pain should improve almost immediately.
• Immobilization- After closed reduction, wearing a sling for a few weeks can keep the shoulder from moving while it heals. A Sling or a brace is required to immobilize the arm, allowing it to heal.
• Rehabilitation- When the splint or sling is no longer in use, a rehabilitation program can help restore the range of motion, strength, and stability of the shoulder joint.
• Surgery- Is used on those with weak shoulder joints or who have repeated shoulder dislocations despite strengthening and rehabilitation. It is done to repair shoulder tissues under a general anesthetic. Sometimes it's necessary to have open surgery to move bones around in the shoulder to prevent further dislocations. In some cases, damaged nerves or blood vessels might require surgery. Surgical treatment might also reduce the risk of re-injury in young athletes.

It is appropriate to seek medical attention promptly if a shoulder dislocation is suspected, as delaying treatment can lead to long-term complications such as chronic pain, instability, and recurrent dislocations.