Shoulder dislocation treatment is important to relieve pain and return the ability to move. The shoulder joint is the most flexible joint in movement, but it is also the joint most susceptible to dislocation due to its flexibility.
Overview of shoulder dislocation treatment in Turkey
The shoulder joint consists of a ball that lives in a hole (cavity), which gives it freedom of movement. The ball is the head of the rounded humerus bone, which has a smooth articulating surface to facilitate movement (the humerus is the bone in the arm), and the hole is the glenoid socket in the scapula bone.
The two articular surfaces of these bones cover a capsule containing a lubricating fluid to facilitate movement. Many ligaments support the shoulder joint to strengthen and hold it in place. Some blood vessels and nerves, in addition to the tendons of some muscles, also pass through the joint.
Because the patient suffers from pain in the event of a dislocated shoulder and cannot move his arm correctly, he will come to medical care immediately to treat the shoulder dislocation, which includes returning the dislocated bone to its place. Still, sometimes we may need surgical intervention for treatment.
Shoulder dislocation symptoms
Symptoms of a dislocated shoulder in patients include the following:
- Severe acute pain in the upper arm, which is the main symptom
- A rounded protrusion under the skin that may represent the head of a dislocated bone (humerus)
- Changing the shape of the shoulder, it may look like a square angle (normal to be round)
- Inability to move the arm or move it with difficulty due to pain and muscle spasm in the arm
- Swelling in the shoulder
- Muscle spasm because the injury caused muscle injury
- Numbness in the area (i.e. loss of sensation) and weakness in the muscles due to injury to the nerves in the area
Shoulder dislocation causes
Causes of a dislocated shoulder include:
- Falling on the shoulder or putting weight on the shoulder joint during a fall (such as falling due to imbalance when walking on ice)
- Sports accidents in violent sports such as an injury in American football
- Exposure to a strong shock, such as in car accidents or traffic accidents
- Electric shocks or severe epileptic seizures
- Shoulder dislocation in children may occur due to the wrong handling of the child or pulling him from his hand forcefully
Causes of recurrent shoulder dislocation (predislocated shoulder)
They are the factors that lead to the repeated exit of the spherical head from the articular fossa.
- Using the joint frequently and severely leads to the stretching of the ligaments that fix the joint and the surrounding tissues and thus dislocate it. This is in some sports that depend on the shoulder joint, such as tennis, volleyball, and swimming.
- The occurrence of a previous shoulder dislocation because when the dislocation occurs, the tissues adjacent to the joint are stretched and are no longer able to fix it well, so even after the treatment of the shoulder dislocation and the return of the bone to its place, it remains not set in its place, leading to the occurrence of recurrent shoulder dislocation.
- The occurrence of shoulder dislocation in young adults (less than 20 years) for the first time causes recurrent shoulder dislocation in the future (more commonly than at younger ages).
- For genetic reasons, some people have a defect in the structure of the tissues adjacent to the joint and fixed to it, which causes partial and frequent dislocations in those people who adapt to this matter and learn how to restore the joint as it was, and that the occurrence of complete dislocation is more common than other people.
Complete dislocation is when the bone is entirely out of its hole in the joint, while in partial dislocation, the bone is displaced from its place without the spherical head coming out of the hole ultimately.
Types of shoulder dislocation
There are three ways in which a shoulder dislocation occurs:
- Anterior shoulder joint dislocation: It is the most common, which is the exit of the head of the humerus from the hole and its protrusion forward and may become visible under the skin. It often occurs in sports injuries, such as tennis players, or in the event of a fall backward on the arm while outstretched.
- Posterior shoulder dislocation: It is less common, and here the head of the humerus comes out of the hole and is pushed back and observed; in this case, it is more complex than the anterior dislocation, and the posterior dislocation occurs when electric shocks or the possibility of severe epileptic seizures, and it is common among athletes and power players because they carry hefty weights.
- Lower shoulder joint dislocation: It is the rarest, which is the descent of the head of the humerus down from the glenoid fossa, and is caused by a blow over the arm while it is extended away from the body.
To differentiate between them and to confirm the presence of the dislocation or accompany it with a fracture, the doctor requests an x-ray of the shoulder.
Shoulder dislocation complications
Due to the tension in the tissues adjacent to the shoulder joint, the complications of a shoulder dislocation will be as follows:
- Damage to blood vessels and nerves in the shoulder joint area
- Tear in the tendons, ligaments, and muscles surrounding the joint
Methods of treating shoulder dislocation
If you feel a dislocation of the bones in your shoulder joint, you should do the following:
- You should hold your hand and not try to move it
- Try tying it up with some shoulder strap and take a pain reliever
- Put an ice pack (cold compress) on your affected shoulder to relieve swelling and reduce the pain of a dislocated shoulder
- Go to the nearest hospital or health care center to treat the case
Do not try to restore the dislocation on your own or with the help of someone because if you try to fix the dislocation, the blood vessels and nerves in the area will be severely damaged and may cause a rupture in the tissues adjacent to the joint, which requires surgery for treatment in this case. Hence, the response to shoulder dislocation is exclusively for the patient by a specialist.
The methods of treating a dislocated shoulder are as follows:
Closed Reduction In Shoulder Dislocation Treatment
It is the primary treatment in cases of shoulder dislocation, where the doctor returns the joint bone that came out by rotating it until it enters its place, and the joint returns to its position; this process takes a few minutes. In the event of swelling, muscle spasms, and pain, the doctor will give you analgesics and antispasmodics. Still, general anesthesia may be needed in severe cases to treat joint dislocation.
After the shoulder dislocation is restored, the doctor will perform an x-ray to ensure that the shoulder joint returns to its normal position; the pain usually goes away at the moment of response immediately or shortly after in the treatment of closed shoulder dislocation, then you will wear the shoulder sling for several weeks according to the doctor's recommendations. Still, the total recovery Return to normal may take 12 to 16 weeks.
The specialist will prescribe some painkillers for you after the dislocation treatment. After removing the shoulder sling, you will follow a rehabilitation program, physiotherapy, and some exercises at home to strengthen the ligaments and support the joint to ensure the shoulder joint's safety and not to recur the dislocation of the joint.
Surgery In Dislocated Shoulder Joint
Surgery will be the treatment method in case of a fracture or rupture of ligaments and tendons in the shoulder joint or if the shoulder dislocation is repeated more than once. The surgery includes either arthroscopic joint surgery through small incisions or open surgery.
Surgery is an excellent option for treating recurrent shoulder joint dislocation because it treats torn tissues and strengthens and supports the joint. The results also proved that the possibility of recurring dislocation after surgery is less than after a fast response, meaning that surgery for recurrent shoulder dislocation is better.
Rehabilitation in the treatment of a dislocated shoulder
Suppose the ligaments are not torn but stretched only due to the dislocation. In that case, resorting to surgery to treat a dislocated shoulder is unnecessary. The specialist doctor must recommend some exercises to strengthen and support the shoulder joint more and make it less likely to dislocate once other.
These exercises help restore the shoulder joint's normal range of motion and make it more robust, in addition to protecting the joint from stiffness due to prolonged use of the shoulder sling. You start with light exercises for the joint, and then your doctor increases the intensity of these exercises.
It is advised not to carry heavy weights on the joint, not to use it frequently, to rest it well, and not to move your arm in extreme positions that damage the joint. Applying an ice pack in case of pain and swelling and taking painkillers is also recommended.
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After treating the patient's shoulder dislocation with closed Reduction and performing rehabilitation exercises and physiotherapy, the shoulder joint should be returned to almost as standard with the return of the field and ability to move the joint as it was. Still, it is recommended to avoid severe pressure on the joint.
Shoulder pain and swelling with muscle spasms and a change in the shoulder shape or the presence of bony lumps protruding under the skin are all signs of a shoulder dislocation that requires treatment.
The risk of dislocating the shoulder is due to damage to the elements adjacent to this joint, such as nerves, blood vessels, and ligaments, and here we may resort to surgical treatment. Therefore, a shoulder dislocation is dangerous if these adjacent areas are injured and require immediate treatment.
How to treat shoulder joint dislocation in children is the same as in adults. The child's hand is fixed, some ice is placed, he is given a pain reliever, and he goes to the nearest hospital or health care center, taking into account the immobilization of the child's hand and not moving it and not trying to return the dislocation except by specialists.
After treatment of a closed shoulder dislocation by the doctor, the doctor will prescribe a shoulder sling that will be placed for several days or weeks. The total recovery will take about 12 to 16 weeks, but you will return to your everyday life after 2 to 4 weeks, during which you will have to be absent from work to rest your shoulder.
But you must avoid sports that require the work of the shoulder joint and lifting heavy objects for a period of one and a half to three months until the joint returns to normal, and of course, if the dislocation is accompanied by a fracture, the recovery period for the treatment of the joint will be more than that.