Shoulder Dislocations

Shoulder dislocations are a common shoulder injury that occurs when the ball of the shoulder ( humeral head ) joint comes out of its normal position on the socket ( glenoid ). These injuries are usually traumatic and can occur with a fall any usually with the shoulder in an elevated ( above the head ) or extended ( reaching backward ) position. Often times there is significant pain while the joint is dislocation and if the ball does not slide back on its own, a medical provider is needed to aid re-aligning the joint.

The shoulder joint ( called the glenoumeral joint ) is a ball-and-socket joint. The shoulder joint has some bony stability but a large part of maintaining its position is soft tissue controlled ( muscle and tendons ) and this allows a large arc of motion- joint in the body allows more motion than the shoulder.

Shoulder dislocations are often confused with a shoulder separation. These are significantly different injuries and a trained physician can distinguish these two injuires as the treatment and management is vastly different. A shoulder separation occurs when the collar bone loses contact with the shoulder blade and is an injury of the acromioclavicular joint.

Shoulder dislocations usually present with significant pain as well as limited range of motion of the shoulder. Often a visual deformity with loss of the normal rounded contour of the shoulder muscle is seen. Diagnosis of a shoulder dislocation is made with a detailed history and examination as well x-rays as there is a high association of bone fractures with shoulder disolcations.

Initial treatment includes properly repositioning the joint ( reducing the dislocation ). The most significant decision is to determine whether surgery may be needed to restore normal function and limit recurrences. The essential lesion with a dislocation is tearing of the soft cartilage in the shoulder ( the labrum ). Often times, immobilzation and physical therapy can achieve normal shoulder function but not uncommonly surgery is needed to optimize shoulder function and recovery. Usually surgery is performed arthroscopically as an outpatient, ambulatory procedure.

Author

William Schell, MD

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