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Dislocated shoulder: how to recognize and treat

03 March 2020
Dislocated shoulder: how to recognize and treat
The shoulder joint is one of the most mobile joints in the human body. The mobility of the joint makes it possible to raise hands and wind them behind the head.

With damage to the shoulder joint, a person can no longer move the limb. Poorly treated trauma leads to repeated dislocations. Injury occurs during any careless movement, for example, when putting hands behind the head during sleep. In this article, we will tell you how to recognize a dislocated shoulder and how to treat this injury.


Anatomy of the Shoulder Joint

The shoulder joint consists of two bones: the clavicle (collarbone) and scapula (shoulder blade). The head, that is, the upper part of the humerus, is in contact with the glenoid cavity of the scapula. The head is fixed in the joint with the rim, glenoid labrum.

The joint is surrounded by a capsule consisting of connective tissue, i.e. ligaments. They fix the upper part of the humerus in the correct position relative to the glenoid cavity. Muscles and tendons surround the shoulder joint as well.

The joint performs a large number of movements and is constantly under high pressure. An external force, such as a fall, may cause a displacement - the upper part of the humerus will change position relative to the glenoid cavity.


What are the types of shoulder dislocations?

Depending on the direction of displacement of the humeral head, several types of dislocations are distinguished.

  • Dislocation is considered anterior if the top of the humerus is displaced forward, toward the front of the body. Displacement may be accompanied by damage to the glenoid labrum. This type of injury is called Bankart lesion. Another unpleasant complication is rupture of the joint capsule. Anterior dislocations occur during sports, when repeating amplitude movements of the shoulder, throws, falling on the back of the straight arm or shoulder.
  • When the head of the bone of the shoulder moves back, it is called a posterior dislocation. Such injuries occur much less frequently than anterior dislocation. Dislocation may occur from a stroke to the shoulder, while the glenoid labrum tear.
  • An inferior dislocation occurs when the displacement of the humeral head occurs in a downward direction. Injury may occur during training on a horizontal bar. This is the least common form of shoulder dislocation. Diagnosing an inferior dislocation is very simple - a person is not able to lower the arm.

If the dislocation in the shoulder joint occurs for the first time, this is called primary dislocation. Usually the cause of which is an injury.

When the humerus begins to move in the shoulder joint, this is called the habitual dislocation. The condition becomes chronic. Most patients with a primary dislocation of the shoulder already have injured the shoulder joint bedore. The injury was accompanied by a tear of the glenoid labrum - cartilage, which fixes the humerus head.


How to Recognize Shoulder Dislocation?

The primary dislocation will certainly make itself felt with a sharp pain in the shoulder area. The hand can no longer move normally, swelling develops.

Deformation may be observed - under the skin, the head of the humerus, which is not in place, will be examined. The shoulder, forearm and even the hand may become numb, a tingling sensation will appear.

If the injury is not treated properly, dislocations will repeat regularly. Big pressure is not necessary, just one awkward movement may be enough. In this case, the patient will not experience such severe pain as during the primary injury. The patient will even be able to correct the dislocation, however, under the pressure, injury will occur again. Habitual dislocations cannot be cured on their own; surgery is necessary.


Diagnosis of Shoulder Dislocation

Firstly, the doctor examines the patient and finds out the circumstances that caused the injury. Then the patient undergoes an X-ray examination through several projections. This should be enough to determine whether the head of the shoulder bone is correctly positioned.

X-ray imaging also represents if the bones are damaged. Dislocation of the shoulder may be accompanied by a bone fracture. In this case, it is not just a dislocation, but a fracture as well.

If the X-ray examination does not provide enough data about the damage, CT and MRI may be prescribed. Examinations help to obtain data on the condition of tissues, ligaments, bones and muscles.

The Caucasus Medical Center in Tbilisi offers patients the diagnosis and treatment of various injuries. Thousands of patients annually come to the hospital not only from Georgia but also from other countries.

The center is equipped with modern equipment, which allows getting the results quickly. The hospital employs experienced doctors who can accurately perform diagnosis and begin treatment. You won’t have to wait long - the diagnosis is made within one day. In the hospital, chronic and professional injuries are treated, athletes undergo rehabilitation here as well.


Shoulder Dislocation Treatment at the Caucasus Medical Center

After the diagnosis is known, the doctor proceeds to correct the dislocation. Reduction of dislocation may be carried out using several methods: open and closed.

  • The closed method is non-surgical. An anesthetic drug is injected into the patient's joint, after which the traumatologist adjusts the bone head and fixes it in place. If more than 24 hours have passed since the injury, it will be more difficult for the doctor to correct the dislocation, since the muscles have already shortened. Then the reduction will be carried out under anesthesia with the use of muscle relaxants.
  • An open method involves surgery. Surgery is a reliable way to get rid of frequently repeated dislocations. During the operation, the doctor makes an incision and adjusts the patient's joint. There are a large number of different surgeries, the type of surgical intervention depends on the individual case.

If the glenoid labrum is damaged while the displacement of the humerus head, it is restored by surgeons. This is called “Bankart” procedure. The surgery is done through a micro section using an arthroscope, a type of endoscope. Doctors form a rim from the joint capsule and sew it to the bone using fixators as if constructing the glenoid labrum. Surgeries may be aimed at fixing the capsule, strengthening the muscles and ligaments of the shoulder.

Traumatologists of the Caucasus Medical Center will select the right treatment and carry out the surgery within 24 hours. All hospital doctors are highly qualified specialists. Many of them have obtained working experience in clinics in western countries.

The Caucasus Medical Center collaborates with well-known hospitals. This gives patients ability to have additional benefits - they can get the advice of a well-known specialist. In addition, the hospital performs unique surgeries together with the Ministry of Health of Georgia.


Postoperative Recovery

Within 1 - 1.5 months after the operation, the limb should be immobilized, therefore, wearing a fixation bandage is mandatory. When the functions of the shoulder joint are restored, the patient is prescribed therapeutic exercises in order to strengthen the muscles. Physiotherapeutic procedures also help to quickly restore shoulder function. After surgery and removal of the retention bandage, an X-ray should be taken to ensure that the humeral head is in the right place.

Patients of the Caucasus Medical Center are supported at all stages of treatment. After surgery, an X-ray examination is done, and if everything is in order, the patient is discharged from the hospital. The doctor gives recommendations for further rehabilitation. You can get a doctor’s consultation after discharge as well, both personally and online.

You can plan an appointment at the Caucasus Medical Center by filling out an application form on the website. Our staff will inform you about the necessary documents and plan an appointment for you. After planning the appointment and paying for the medical services, the medical concierge will help you to find a hotel and an interpreter. The hospital will organize a transfer - you will be met at the airport. The center cooperates with insurance companies worldwide, which means you can reimburse your treatment expenses. Hospital reviews are available on the website of the medical center.