Orthopaedy

Dislocated shoulder

Dislocation – a displacement of articular ends of bones from normal position in a joint. The shoulder joint consists of the scapula, the glenoid cavity, the head of the humerus, articular cartilage, joint capsule, tendon of the biceps muscle, tendon sheath intertubercular. Wide articular shoulder capsule is loosely fitted to the joint, in some places it is especially fragile and thin. Rostral-shoulder ligament is very important; most of its fiber is woven into the capsule. Periodicity of dislocated shoulder is explained by the peculiarities of the anatomical structure of the shoulder joint (eg, shallow glenoid cavity scapula) and large amplitude movements in it.

Symptoms

  • Movement of the shoulder joint is limited.
  • You have already had a dislocated shoulder earlier.
  • Dislocated shoulder with normal hand motion.
  • Asymmetry of the shoulder girdle.
  • Paralysis of individual muscles and muscle groups.
  • Abnormal mobility of the shoulder joint.

Causes

Often the cause of dislocated shoulder – flattened glenoid cavity scapula (due to dysplasia). This anomaly is congenital. The most common cause of habitual dislocation is the primary traumatic dislocation of the shoulder at the drop of a brush or elbow, where the head of the humerus falls out of the glenoid cavity. Dislocation is possible and when rotating the hand in the shoulder joint with a large amplitude. With each subsequent dislocation of the shoulder the elasticity of the wide joint capsule decreases. Often there are gaps of the joint capsule in the place where the articular head comes out of the glenoid cavity, accompanied by possible sprains and even muscle tears.

The cause of limiting movement – pain caused by compression of the brachial plexus due to dislocation. In addition, sometimes prolonged abnormal mobility of the shoulder joint can cause arthritis.

Treatment

Dislocated bones are returned to the correct position by reposition, which is performed under local or general anesthesia. If the cause of dislocation is dysplasia is glenoid cavity, the patient is recommended surgery to stabilize the shoulder joint on Eden method, that has been used successfully for many years. Part of the bone is attached to the lower edge of the glenoid cavity, thus creating a kind of barrier that prevents the free exit of the joint head. After the operation, it is necessary to prevent the movement of ankylosis (joint immobility) and the strengthening of the periarticular muscles. The joint head is held in the right position due to well-developed muscles. Therefore, when the dislocated shoulder happens after a traumatic dislocation, the patient is needed physiotherapy.

Often the success of treatment is predetermined by the effort of the patient, who must comply strictly with physical therapy exercises.

If dislocated shoulder repeated, it is necessary to see a doctor, better – orthopedist.

The doctor will examine the joint and determine its degree of mobility, perform X-rays, ask about what has happened. Depending on the cause of dislocation doctor will prescribe exercise therapy or recommend surgery.

Course of the disease

Displacement of joint head is possible with the most common movements. There are anterior, and posterior shoulder dislocations. The vast majority of a dislocated shoulder – anterior; posterior shoulder dislocations are rare. When there is dislocation, patients complain of severe pain in the joint. Active movements are impossible, passive – sharply painful and limited.