The shoulder or gleno humeral joint is the junction of the upper end of the humerus and the glenoid cavity.(Anatomy). A group of four muscles and their respective tendons, known as the rotator cuff, stabilizes the joint, and allows the upper arm to be lifted by the Deltoid muscle. In a dislocation, the humerus is forced out of the glenoid cavity by a strong blow or severe weakness of the rotator muscles. A dislocation can occur in one of three directions, anterior (forward), posterior (backward), and inferior (downward). An anterior dislocation of the shoulder is by far the most common dislocation. Because of the great range of motion allowed by the shoulder joint, it is the most-frequently dislocated joint in the body. A partial dislocation of the shoulder is known as a Subluxation. A full dislocation is very painful, There is always a tear of the glenoid labrum or capsule from its attachment to the glenoid. This often does not heal properly increasing the chance of recurrent dislocation or a condition known as instability
Detailed Description
Symptoms · Extreme pain · Noticeable abnormality of the shoulder when compared to other · Swelling, bruising and tenderness · Possible loss of sensation and weakness of the Deltoid if the axillary (armpit) nerve is damaged.
Causes and Risk Factors
Causes Since shoulder dislocations most often occur in the anterior (frontward) direction, the most common way to dislocate it is to suffer a backwards blow while the shoulder is raised. Risk Factors Wrestlers, basketball players and football players comprise the biggest risk group for shoulder dislocations. Twisting, lifting and hitting, as well as throwing sports, also pose a higher risk of dislocation.
Treatment
Immediate Action: If a dislocation is suspected, gently place the arm in the most comfortable position across the chest. If this is not possible, use medical tape or bandages to secure the arm gently to the side of the body. Do not try to force the bones back into place, as this will often worsen the condition. Seek a doctor or emergency room immediately.
Procedures
The Orthopaedic surgeon will perform a reduction, or relocation of the shoulder, to place the head of the humerus back into the glenoid socket. Following the procedure, the surgeon will ask you to wear a sling for three to four weeks. For recurrent dislocations or subluxations, open shoulder stabilization or Arthroscopic Stabilization is advised. The procedure is done as a day care procedure under general anesthesia.
Prevention
Strong rotator cuff muscles remain the strongest defense against shoulder dislocation. Exercises that build up these muscles around the shoulder should be done. Adequate warm-up before activity and avoidance of high-contact sports will help prevent a dislocation. |
