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Patient Education >> Shoulder Conditions >>Shoulder Dislocation


 

   

 


 

 

WHAT IS SHOULDER DISLOCATION?



The shoulder is the most mobile joint in the body and is prone to dislocation. This is because of the mismatch between the ball and the socket. The main stabilising factors include the sac or the capsule of the shoulder which is strengthened by three ligaments and a lip which deepens the saucer shaped cup known as the labrum. If the congruity between the ball and the socket is lost the joint is said to be dislocated.

WHAT IS THE CAUSE OF DISLOCATION?



The most common cause of a shoulder dislocation is a traumatic event. This could be falling onto an outstretched arm or a direct blow to the shoulder like a rugby tackle. Sudden wrenching motion or a pulling motion can also cause a dislocation. The shoulder commonly dislocates to the front and below the socket. This is very painful and can cause symptoms of pins and needles and a dead feeling in the whole of the arm. If this happens at a sporting event like a rugby or football game the shoulder is often put back on the field. Alternatively this is done in the Accident and Emergency department.

WHAT ARE THE SYMPTOMS?

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The patient may complain of pain with overhead activity. A sensation of popping, locking or grinding may be felt. A feeling that the shoulder may come out in certain positions is a symptom of chronic instability. The most common position is the arm being moved outwards and above shoulder level. Obviously the shoulder may dislocate again.
The younger the patient and the more athletically active, the greater the chance of the shoulder redislocating. Various studies have shown that patients under the age of twenty-five have the highest risk. The force required to dislocate the shoulder keeps decreasing with increasing episodes.



HOW IS THIS DIAGNOSED?

 

 



A good history and an examination are often adequate to diagnose the problem. It may be necessary to perform an MRI scan with a dye to confirm the diagnosis and also to identify the damage done to the structures within the shoulder joint.



WHAT IS THE TREATMENT?

 

 

 

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 The treatment for initial dislocations is immobilisation for a period of time in a sling to allow the tissues to heal. This is followed by physiotherapy. Surgery in recurrent dislocation is a good option. A small half centimeter incision is made over the posterior aspect behind the shoulder and a telescope is introduced. Fluid is injected into the shoulder for better visualisation. Two further holes are made into the front through which instruments are introduced. The damaged ligaments and the lip of the cup are first identified and tears noted. The edges of these tears are freshened and repaired using anchors and sutures.

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