A shoulder dislocation is what occurs when we say colloquially shoulder“has slipped out of place” due to major trauma.
Figure 1:Left:dislocated shoulder. Right:shoulder in place
Due to the ruptured ligaments, the humeral head“exit” and no longer in contact with the glenoid ( the surface of a bone cavity in which fits the head of another bone). This produces excruciating pain and the patient needs to go to an emergency center for medical“replace it in place”.
Up to 1/3 of these injuries do not heal well and become recurrent. This means that, with minimal movements, plays the dislocation, resulting in significant functional limitations in patients. This percentage may increase to 85% if we talk about men young practitioners of contact sports and dominant arm.
Once there have been two episodes, and especially the 2ºHe has been with minimal trauma, we can say that dislocation will Recurrent and it will go repeating over time. The more episodes of dislocation have been produced and more time evolution brings injury keychain worn more and more injuries associated tissues may have, leading more difficult to repair.
injured ligaments are the primary stabilizers of the shoulder. The muscles surrounding the shoulder are secondary stabilizers. Once you have become recurrent, the only way to fix 100% is the surgery because the ligaments are repaired. The toning of the muscles by rehabilitation can help, but in no event will solve the problem, or to prevent further episodes safely.
As in other arthroscopic techniques, is introduced through small incisions a camera that allows us to view, complete and much better than with open surgery, the entire joint.
Usually injured ligaments are“& rdquo torn;bone, therefore, by small“screws” biocompatible 1’5mm, let“sewing” the torn ligament, to put everything back in place.
Fig 2:arthroscopic shoulder to the top of the labrum&ldquo observed;disengaged” your site.
Figure 3:Shoulder arthroscopy with implants and the thread used to repair the lesion.
Depending on the size of the lesion and the various injured structures, we use the number of implants required. All this can be done by mabulatoria and usually tend to use regional anesthesia with sedation for patient safety.
After the intervention the patient can go home the same day with his arm in a sling. Of generic way, the next day you can begin to withdraw the sling for eating, reading, typing computer… and physical therapy with passive movement starts.
will gradually starting more intensive exercises, so that, at approximately 6-8 weeks the patient can move the shoulder completely actively, and before he resumes sport on authorizing 4 months
Risk of re suffering a dislocation
At surgically intervene, we again leave everything“in place&rdquo ;, this means that if the patient returns to suffer another injury, you can re-produce the lesion.
This should not be played with movements and more sports“normal” ( swimming, Workout, tennis&hellip ;) although the indices of relapse may vary between 3-10% depending on the series. Risk factors that predispose to new dislocations are contact sports, patients with hypermobility, type of injury and most often young men.