Shoulder Dislocations

Shoulder Dislocations

Shoulder injuries are a common reason for an orthopedic visit.  Many involve the rotator cuff and are seen in patients over the age of forty.  These patients have pain, weakness and limited range of motion of the shoulder.

Another type of injury that we see are shoulder instability problems.  These patients will come in complaining that their shoulder either completely dislocates or more common they feel like it wants to partially dislocate. We call partial dislocations, subluxation.  They can occur on a daily basis or with a true dislocation  less frequently. With some dislocations the patient will have to go to the ER in order to get it reduced.  Either way the diagnosis needs to be established as well as a treatment plan.

Studies show that if a shoulder dislocates more then once then there is a 100% chance that it will continue to dislocate.  After the diagnosis is confirmed with a physical exam and MRI, conservative treatment is always tried for first time dislocators and subluxations.  However, with multiple dislocations surgery is almost always necessary. 

The labrum is the soft tissue  that forms a ring around the socket or glenoid of the shoulder joint.   The labrum acts like a bumper to prevent the shoulder from dislocating.  With a tear there is no bumper effect and the shoulder can dislocate.  

Arthroscopic surgery is done to repair the labrum.  We are able to do this using small 1/2" incisions in which we place several sutures to repair the labrum and thus restore the bumper effect. Patients usually have immediate relief as their shoulder is stabilized.  Physical therapy is still necessary to help regain shoulder range of motion, but patients do well and can resume all activities. 

 

Author
Bruce I. Prager, M.D.

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