Being the most mobile joint in the body, the shoulder has more degree of freedom than any other joint of the body. But, this advantage also proves to be a disadvantage that makes the shoulder an easy joint to dislocate. The most common type of dislocation is the anterior shoulder dislocation. It usually results from forced abduction (shift away from position), external rotation and extension in the shoulder.
The largest group afflicted by this condition is the younger age group, who has either sustained injuries to the shoulder or has been aggressive during sporting activities. The second group is older patients who have been injured with a much milder violence.
When the shoulder dislocates, the nerves in the shoulder area can get stretched out. Some patients report stingers or numbness running down their arm at the time of the dislocation.
It is important to communicate with the doctor about the entire history of the injury. For example, if a visit to the emergency department had been made to have the shoulder reduced. If so, a radiograph of the dislocated shoulder will likely be the next course of action. If not, it needs to be known if they popped their shoulder back in or if it just went back in by itself. This can aid the treating physician in understanding how loose the shoulder has become.
Nearly 95% of shoulder dislocations result from a major traumatic event, and 5% result from less severe causes. Distinguishing the type and severity of the event is crucial in determining the true cause of the dislocation and decide the subsequent treatment path.
- The preferred course of treatment is closed reduction with or without anesthesia. This non-invasive method is usually performed with light sedation and /or analgesia. In the process, the joint is manipulated back into anatomic alignment and immobilized. Occasionally general anesthetic may be required.
- MRI may be indicated sometimes, and it may show some associated lesions like hillsachs defect or labrum tear.
- Surgical repair of the labrum is required only in very active individuals like competitive athletes who have a higher risk of getting a recurrence of this problem.
The healing process from there on is a structured course of physical therapy aimed at reducing muscle wasting and maintaining mobility.