Shoulder Dislocations and Instability
shoulder dislocation and instability
The shallow ball-and-socket joint of the shoulder is the most frequently dislocated major joint in the human body. Most often, the shoulder dislocates as the upper arm bone (humerus) comes forward out of the joint.
Most people with axillary nerve damage recover without treatment, as the symptoms go away when the shoulder is put back in position. Less commonly there may be damage to the brachial plexus, which is a network of nerves that run from the neck and supply the arm.
This is more likely when dislocation occurs with the arm out to the side, with the elbow bent at 90 degrees and the hand hanging down. Again, the recovery from damage to the brachial plexus associated with shoulder dislocation is usually good.
Significant fractures occur in around one quarter of shoulder dislocations, and are more common when there is a traumatic mechanism of injury, first-time dislocation, or the person is aged over forty.If there is a fracture and a piece of bone has moved from where it should be (displaced), then it usually needs surgery.
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Replacing the shoulder back into position and immobilizing it in a sling for a few weeks is the most common treatment. Occasionally surgery may be needed to relocate the joint. Sometimes, a tendency to experience further dislocation. This problem is known as unstable shoulder.
If non-operative treatment in the form of muscle strengthening exercise fails, arthroscopic surgery in early cases and open surgery in late cases is recommended to stabilize the shoulder. Open technique involves transferring of a bone fragment to the deficient glenoid rim- latarjet procedure.
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