Shoulder Dislocation

Dislocation of the shoulder is the commonest dislocation in orthopedic practice comprising of almost 50% of all dislocations that present to an orthopedic clinic. It occurs at all ages, but it most commonly affects young, active males below 30 years of age.

The structure of the shoulder joint can be imagined to be like a golf ball and a tee. At any time only one fourth of a humeral head articulates with the glenoid. Hence the bony articulation is inherently unstable and the prime restraint to dislocation is provided by the soft tissue cover around the joint.

Mechanism of injury

The first episode of shoulder dislocation is usually traumatic. A traumatic anterior shoulder dislocation mostly results from a fall on an outstretched hand with arm in throwing position. More than 90 % of shoulder dislocations are anterior(head of the arm bone dislocates and lies in front of the shoulder blade) and posterior shoulder dislocation(head of the arm bone lies posterior to shoulder blade) are rare. Convulsive disorders and electric shock are the common causes for a posterior dislocation.

Chances of getting shoulder dislocated again after first shoulder dislocation is very high in young people below 25 years.

Management of shoulder dislocation:

X ray is required to confirm dislocation and to see if there is any associated dislocation. A dislocated shoulder should be reduced immediately. Now new methods have been devised , by which Most of the shoulder dislocation can be reduced without pain and sedation.

X ray shows dislocated shoulder.

What you should do for recurrent shoulder dislocation?

Some structural injuries in the shoulder joint (like labral injury) may fail to heal after first episode of shoulder dislocation and may lead to recurrent episodes of the shoulder dislocation. You should learn to avoid some vulnerable positions (like throwing position) which is likely to dislocate your shoulder. Now a days very effective and minimally invasive arthroscopic surgery for  recurrent shoulder dislocation is available. In arthroscopic repair torn labrum is again fixed to the bone with suture anchors.

Throwing position is often painful in a patient of recurrent shoulder dislocation