Shoulder dislocations should be treated with immediacy and professionalism to soothe intense pain and ensure a good outcome. The shoulder is the most prone to dislocation of the entire human body; so cases of dislocation occur very frequently.
To reposition the shoulder back in place, doctors must execute specialized maneuvers adapted to the type of dislocation that the patient presents; This can be either a complete dislocation (anterior or posterior) or a partial subluxation.
Shoulder dislocations are initially diagnosed with a manual assessment, where we palpate the joint to locate the point of injury; Additionally, the patient is given a clinical examination (anamnesis) with a series of questions to find out how the dislocation occurred, how strong the intensity of the pain is and how unstable the limb is.
It is very common that an imaging diagnostic method such as X-rays is also added to the examination; This, in addition to validating the diagnosis, will also serve to rule out the existence of an internal fracture or any other nerve or vascular alteration.
The most common shoulder dislocations are:
It occurs when the head of the humerus suffers a strong displacement in front of the glenohumeral joint; approximately 95% of dislocations correspond to this type.
It happens when the displacement of the humerus occurs backward or below the shoulder joint. Posterior dislocations usually occur in people who have had a seizure or electric shock; therefore, the chances of a posterior dislocation are reduced to 2% or 5% of all cases.
There are a variety of methods to put the joint back in place. Depending on the characteristics of the dislocation, they may or may not need sedatives.
It is important to note that any of these shoulder repositioning techniques must be applied by a specialist; otherwise, a more severe complication could be generated.
Among the most commonly used non-surgical treatments are:
Traction-countertraction technique.
Hennepin technique.
Scapular manipulation.
Cunningham massage.
Fares Technique.
Davos technique.
Stimson's technique.
Once the reduction is completed, the joint is immobilized with the help of a sling to prevent rotations for the time suggested by the treating physician.
A dislocated shoulder not only leaves a “visibly protruding or misplaced shoulder”, it can also bring other problems such as: tears in muscles, tendons or ligaments; damage to the blood vessels or nerves near the joint, instability, among others.
To solve this type of internal injury, it is necessary to resort to a surgical repair procedure, which can be:
It is a minimally invasive surgery, in which small cuts are made around the shoulder to introduce the arthroscope and some special instruments, which will allow the doctor to fix the affected parts.
This operation requires a larger incision to directly visualize the injury and have a wider space to correct the damage.
When the shoulder is dislocated, it shows a different appearance to the naked eye, because the humerus is displaced out of its normal socket. Other signs that accompany a shoulder dislocation include:
Swelling or bruising around the joint area.
Severe pain.
Inability to move the limb.
Feeling numb.
Muscle spasms.
It is a joint problem that originates when the upper end of the humerus leaves its location within the shoulder blade. For this to happen, the shoulder had to undergo blunt force trauma, a direct contact sports injury; or failing that, being exposed to repetitive stress that has caused severe wear and tear on their functional structures.
Shoulder dislocations can recur, but if this happens more than once, the patient is likely experiencing chronic shoulder instability.
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