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Shoulder dislocation


It sometimes happens that the shoulder is dislocated from the socket and it either is wrenched upward or backward. This leads to incapacitation and an immense amount of pain. Shoulder dislocations, in general, happen due to falling on a hard surface. The lower front portion of the shoulder is usually affected in most of the cases. There is a term used in medical science called subluxation. This means the partial dislocation of the shoulder. When the joint surfaces of the shoulder lose contact with each other, that is when shoulder dislocation occurs.

Anatomy of Shoulder

Shoulder joint enjoys the mobility at the cost of Stability.

It is the most mobile joint in the body but one of the least stable joint therefore one of the most frequently dislocating joint in the body. Anatomy of the shoulder is such that it allows free movement in all directions. Humeral head (arm bone) articulates with glenoid on the scapula (shoulder blade bone)

Imagine a dish which has flat central part and elevated edge all around periphery. If you have to place a large ball (ball of double the size of dish) in the dish , it will stay in the dish because of the elevated edge of the dish. If the edge of the dish is broken ball will roll out and won’t remain in the dish.

Glenoid is like Saucer or Dish which has central flat part and elevated edge. The Humeral head is much bigger in size as compared to glenoid. In the Glenoid the elevated edge is formed by Labrum. If the edge of the glenoid is broken (i.e. Labrum is torn or edge of the glenoid is fractured) the Humeral head (ball) tends to slip out of the glenoid and results in dislocation.

Shoulder Dislocation
Shoulder Dislocation
Shoulder Dislocation

What are the causes of shoulder dislocation?

The most common reasons of shoulder dislocation are as follows:

  • Traumatic injuries often lead to the dislocation of the shoulder from its joint. These injuries often include car accidents or even a lethal sports injury.
  • There are certain types of sports which lead to the overuse of the shoulder joint. In these sports there is a constant movement of the arm which is vigorous in intensity. Some of these sports include volleyball, tennis, swimming, kabaddi, and even golf. All these sports often lead to shoulder dislocations when there is an injury.
  • If you fall from a great height over a hard surface, the impact that results is great and often leads to shoulder dislocations.
  •  a seizure or a severe electric shock. Seizures and shock can cause shoulder dislocations because they produce extreme, unbalanced muscle contractions that can wrench the humerus out of place.

What are the symptoms of shoulder dislocations?

The symptoms that are usually encountered by people in case of shoulder dislocations are as follows:

  • The major symptoms from which you will know that something is wrong is an excruciating pain in the shoulder region.
  • Since your shoulder joint plays an immense role in the movement of your arm, you will face great difficulty in the slightest movement of your arm.
  • If you touch your own shoulder joint, you will feel as if the joint is no more there and a physical deformity is prominent.
  • you may be able to see a lump or bulge (the top of the arm bone) under the skin in front of your shoulder
  • The upper arm region may feel numb and there might even be a weak feeling. Some people also complain of a tingling feeling in the affected region and the upper arm.
  • There might even be pop noises in your shoulder.
  • If the injury is acute, a swelling is prominent along with dark bruises.

Prevention

If you have had a dislocated shoulder, you may be able to prevent a repeat injury by doing shoulder strengthening exercises recommended by your doctor or physical therapist. Once you have dislocated your shoulder, you are more likely to dislocate it again, particularly if you play a contact sport.

What are the treatment procedures for shoulder dislocation?

DO NOT try to reduce shoulder forcibly by quacks as it causes more injuries inside the shoulder joint.

The possible treatment measures for treating a dislocated shoulder are as follows:

  • Once you have been confirmed about the extent of the injury, our doctors will give you the appropriate medicines that will reduce the pain. With the help of these medicines, your muscles will be able to relax.
  • Initial treatment is reduction after proper muscle relaxation or anaesthesia.
  • Once Shoulder is dislocated, there is very high chance of dislocation in future. Most of the cases require surgical treatment
  • Many different types of techniques for treating a dislocated shoulder is available right from physiotherapy, exercise to surgery. You will be treated depending on the position and extent of the injury.
  • A shoulder immobilizer or sling will be given to you after your surgery which you will have to wear for a certain period of time until your shoulder recovers fully.
  • Rehabilitation of your normal movements can be done through physical therapy.

Our clinic has all the state-of-art infrastructure required to treat a shoulder dislocation. No matter how grave the injury is, you will be able to resume your normal life after getting the treatment from our clinic.

Prognosis

The outlook depends on many factors, including the severity of your shoulder injury, your age and your participation in athletic activity. For example, if you are a teenaged athlete and you play contact sports, such as football or hockey, after a shoulder dislocation, your overall risk of a second shoulder dislocation may be as high as 90%. Repeat injury may make your shoulder unstable enough that it needs to be repaired with surgery. Surgery usually restores the shoulder's stability and reduces the risk of future dislocation to 5% or less.

If you are an adult and have an uncomplicated shoulder dislocation, your risk of a second dislocation is low, with repeat dislocations occurring less frequently for people in their 30s and even less often for older age groups.

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DR SHAILESH KESHAV MISHRA

Consultant Orthopedic, Joint Replacement and Arthroscopy Surgeon

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