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Shoulder Injury : DislocationReview shoulder injury: (general) in the INJURY FILE before reviewing this section.The shoulder joint is composed of two main bones: the SCAPULA (shoulder blade), which provides the socket for the shoulder and the HUMERUS (arm bone), which "fits" into the socket of the scapula. The joint is stabilized by tough, fibrous bands known as ligaments. This joint can dislocate if the force applied is great enough to tear the ligaments. An abrupt forceful motion, putting the arm high above the head with the palm rotated in towards the face, almost facing the back, sets the stage for shoulder dislocation. In this [common] mode of dislocation, the "ball" end of the humerus, normally secure in the joint, painfully "pops" forward toward the chest muscle, where it becomes lodged in the dislocated position. Many patients become "repeat dislocators," due to the destruction of the anterior (front) lip of the joint during the initial dislocation. Chronic joint instability is the eventual result, particularly when the arm is abruptly brought over the head. ommon signs include a patient with their arm in a position, as if in a sling, unwilling to attempt raising their elbow to shoulder level. The normal contour of the shoulder is distorted with a "flattening" along the outer aspect of the shoulder. common symptom of shoulder dislocation is pain while at rest, which increases dramatically with attempted movement. History for a prior shoulder dislocation is common. Evaluation will include physical examination for deformity. The head of the humerus may feel like it is out of position, and in front of the joint. An examination for nerve and vascular integrity will be important to rule out the presence of injury to these structures. Bone x-rays will rule out fracture, which can sometimes coexist with a dislocation. Treatment involves the reduction (relocation) of the dislocation. This procedure will be performed by the physician after appropriate pain medications and muscle relaxants are given (usually IV). After the reduction, ice compresses are applied to the shoulder. A sling and swathe (a sling that holds he arm in toward the trunk) is needed to prevent reinjury. Acetaminophen, aspirin, or an anti-inflammatory (ibuprofen) help reduce pain. Chronic dislocators may require a surgical procedure by an Orthopaedic Surgeon to stabilize the joint against future shoulder dislocation. The average recovery period for acute shoulder dislocation is 6 weeks (3 weeks of immobilization). POSTERIOR (toward the back) shoulder dislocation may also occur, but MUCH MORE rarely. Only the most common form, the anterior (toward the front) dislocation has been discussed here. ALL shoulder dislocations require IMMEDIATE medical attention. Hope this article will provide you information about shoulder injury : dislocation.
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