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Concept
Dislocated shoulder
Summary
A dislocated shoulder is a condition in which the head of the humerus is detached from the shoulder joint. Symptoms include shoulder pain and instability. Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve.
A shoulder dislocation often occurs as a result of a fall onto an outstretched arm or onto the shoulder. Diagnosis is typically based on symptoms and confirmed by X-rays. They are classified as anterior, posterior, inferior, and superior with most being anterior.
Treatment is by shoulder reduction which may be accomplished by a number of techniques. These include traction-countertraction, external rotation, scapular manipulation, and the Stimson technique. After reduction X-rays are recommended for verification. The arm may then be placed in a sling for a few weeks. Surgery may be recommended in those with recurrent dislocations.
Not all patients require surgery following a shoulder dislocation. There is moderate quality evidence that patients who receive physical therapy after an acute shoulder dislocation will not experience recurrent dislocations. It has been shown that patients who do not receive surgery after a shoulder dislocation do not experience recurrent dislocations within two years of the initial injury.
About 1.7% of people have a shoulder dislocation within their lifetime. In the United States this is about 24 per 100,000 people per year. They make up about half of major joint dislocations seen in emergency departments. Males are affected more often than females. Most shoulder dislocations occur as a result of sports injuries.
Significant pain, sometimes felt along the arm past the shoulder.
Sensation that the shoulder is slipping out of the joint during abduction and external rotation.
Shoulder and arm held in external rotation (anterior dislocation), or adduction and internal rotation (posterior dislocation). Resistance of all movement.
Numbness of the arm.
Visibly displaced shoulder. Some dislocations result in the shoulder appearing unusually square.
Official source
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