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Shoulder Dislocation

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Shoulder Dislocation

shoulder-dislocation

Shoulder is the most common joint in the body to dislocate. Due to its ball and socket design we have a great deal of mobility within the shoulder, which is directly at the cost of stability.

Shoulder joint socket is formed by bony glenoid and labrum attached to it, while ball is formed by head of humerus (arm bone).  Shoulder dislocates anteriorly far more commonly than posterior. Glenoid labrum is crucial stabilizing factor that tears when shoulder dislocates. It is known as Bankart tear or Bankart lesion. When shoulder dislocates it leads to cuticle depression injury on posterolateral portion of head of humerus known as Hill sach’s lesion.

Traumatic shoulder dislocation usually recurs leading to shoulder instability. Occur frequently in young patients.  If age at first dislocation is in second or third decade chances of recurrence are high. After first traumatic dislocation there is 50-60% possibility of recurrence, while after second episode that increases to more than 90%. With every dislocation it damages Labrum and anterior portion of  glenoid bone. It is usually predisposed by activities like throwing where shoulder is abducted and rotated externally.

Diagnosis

  • MRI – it is a investigation of choice in diagnosing Bankart’s tear.
  • X ray – It is investigation of choice in diagnosing acute dislocation. Specific views help in assessing extent of hill sach’s in recurrent shoulder instability.
  • CT Scan – may be needed in planning of treatment to assess extent of bone loss.

Treatment

  • Acute shoulder dislocation needs to be reduced by orthopaedic surgeon under suitable anaesthesia.
  • Rest in sling, ice , medicines and physical therapy are important
  • In recurrent shoulder instability surgical intervention is needed depending on age, dislocations and bone loss.
  • Arthroscopic Bankart  repair – it is a keyhole surgery where anterior labrum can be repaired to glenoid with the help of suture anchors.
  • Latarjet procedure – this procedure is required if significant bone loss is present. Coracoids process (part of bone scapula) along with its muscle attached is fixed to glenoid rim.

FAQ

What is Bankart tear?

It is tear of antero-inferior glenoid labrum. It develops by traumatic shoulder dislocation.

What is Bankart repair of shoulder?

It is a surgery by which torn glenoid labrum and capsule are repaired back to glenoid rim to restore stability of shoulder joint.

How much time does it take to recover?

It usually take around 8 weeks to recover.

Do I require physiotherapy?

Yes, it is important aspect in recovery. It helps to regain movement and function.

What is Hill Sach’s lesion?

It is a compression fracture on posterolateral portion of head. It happens at the time of dislocation where head slips out of socket and is compressed against glenoid rim.

How soon after surgery can I drive?

It depends on regaining sufficient movement and strength. Usually around 3 months of time is required.