Shoulder dislocation refers to separation of the ball of the shoulder joint (humeral head) from the socket (glenoid). The shoulder is a highly mobile joint that allows a wide range of motion, but this mobility also makes it susceptible to dislocation. Dislocation typically occurs when an external force or trauma forces the ball-shaped head of the humerus out of the shallow socket of the shoulder joint.
There are different types of shoulder dislocations, with anterior (forward) dislocations being the most common. Anterior shoulder dislocations often result from trauma that forces the arm outwards and backwards, resulting in an excessive forward force through the head of the humerus. Posterior (backward) dislocations are less common and usually result from a direct blow or a fall onto the front of the shoulder, forcing the humeral head backwards.
Acute symptoms of a shoulder dislocation may include intense pain, swelling, deformity of the shoulder, and an inability to move the arm. In some cases, there may be numbness or tingling in the arm due to nerve compression.
Immediate treatment for a shoulder dislocation involves reducing the dislocation, which may be done manually by a healthcare professional in a process called closed reduction. After the reduction, the shoulder is usually immobilised with a sling for comfort, and rehabilitation exercises are then initiated to regain strength and range of motion.
Structural damage to the shoulder can occur when the shoulder dislocates. This damage usually involves the labrum, a ring of cartilage that encircles the glenoid(socket) to enhance stability. Other structures such as bone, joint capsule, tendons and nerves can also be damaged. Imaging with CT and MRI scanning is used to assess the extent of structural damage. This structural damage increases the risk of further (recurrent) dislocations, such that after the shoulder dislocates once, it is far more likely to dislocate again. With each recurrent dislocation further structural damage can occur.
To prevent or treat recurrent instability, surgery is often required to repair the damaged structures. This operation is known as a shoulder reconstruction and may involve restoration of the soft tissues (labrum and capsule) known as a Bankart Procedure, or restoration of bone and soft tissues known as a Latarjet Procedure.
Rehabilitation following the surgery begins with a period of immobilisation in a sling for 4 weeks, followed by an intensive physiotherapy program to gradually restore movement and strength to the shoulder, while the repaired tissues heal.
To schedule an appointment with Dr Matthew Evans to discuss your Shoulder Dislocation, please contact us by phone – (03) 9529 3820, or email evansadmin@mog.com.au
