According to experts in Traumatology , shoulder dislocation is a lesion in which there is a loss of contact between the two articular surfaces of the shoulder.
Types of shoulder dislocation: frank dislocation and shoulder subluxation
Shoulder dislocation occurs when the humeral head loses contact with the scapular glenoid.
In cases in which this loss of contact is maintained over time, we speak of a frank or true dislocation , and when the loss of contact occurs only momentarily, we speak of an episode of instability or subluxation of the shoulder .
Also, when talking about shoulder dislocation, we must differentiate whether this displacement of the humeral head has been anterior or posterior , or there is even the possibility of multidirectional displacement.
Why shoulder dislocation occurs
The reason that dislocation occurs in the shoulder more times than in other joints is because it is a joint that has a large range of mobility.
In addition, the glena that receives the humeral head has a third of the diameter of this head, which makes it much more prone to get out.
The dislocation can be caused by direct or traumatic causes : direct trauma to the shoulder, indirect trauma due to some extemporaneous gesture, and some cases, especially in hyperlaxed patients, simple trauma can also cause a shoulder dislocation.
Symptoms of shoulder dislocation
The main symptom is pain and inability to move the injured shoulder, functional impotence, and an apparent deformity in it.
When the patient does not have a first episode of dislocation, but an unstable shoulder that is dislocated repeatedly, this no longer refers to such intense pain, but a feeling of fear or apprehension and avoids making certain movements in which he feels or believe that the shoulder is going to come out.
In addition, in cases of patients with many episodes of repeated instability, what can occur is that the only symptom that the patient feels is pain, and that can sometimes lead to confusion with other shoulder pathologies.. Therefore, a correct differential diagnosis must be made.
Treatment for shoulder dislocation
The first and most urgent step is to reduce the shoulder when dealing with a frank or true dislocation. Shoulder reduction is performed by a series of arm immobilization maneuvers, and in some cases, it may even require general anesthesia.
Once the shoulder is reduced, a period of immobilization is needed, which can vary between 2 and 4 weeks, to allow healing to the structures that have been broken and that have allowed that humeral head to leave its site. After this healing process, there is a rehabilitation process to recover the strength and joint balance of that shoulder.
In repeated dislocation episodes, the treatment must be surgical. Through surgery, damaged structures are repaired, soft tissue stops are made and in some cases, bony stops that prevent the humeral head from coming out again.
Only in some specific cases of first episode of dislocation, in young patients, athletes, dominant shoulder; we can consider a surgery in the first episode of dislocation since the risk of repeating this episode is quite high in this group of patients