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|►Advice sheet on shoulder replacement|
|►Advice sheet on injection|
|►Advice sheet on decompression|
|►Advice sheet on stabilization|
|►Advice sheet on cuff repair|
Dislocation of the shoulder frequently occurs following a fall or forced shoulder movement such as may occur in a rugby tackle. The injury is particularly common in younger patients. The humeral head usually displaces in a forward direction where it becomes stuck because of muscle spasm.
Dislocations will sometimes reduce spontaneously, but more often than not admission to hospital is required so that the dislocation can be reduced under anaesthetic.
When the shoulder dislocates the capsule at the front of the joint is damaged. This does not always heal properly, particularly in young patients (less than 20 years). In this event the shoulder becomes unstable and may dislocate again often with minimal trauma. Further dislocations may or may not require an anaesthetic to relocate the shoulder.
When recurrent dislocation interferes with everyday life (usually after 3 to 4 dislocations) surgical stabilization may be considered. Depending on the exact pathology this may be done either by means of an arthroscope ('keyhole' surgery) or through an incision on the front of the shoulder. In either event your shoulder will need to be immobilized in a sling for 4 to 6 weeks. For further details of surgery click here.
Sometimes the shoulder will start to dislocate for no apparent cause. Typically a patient will notice that their shoulder dislocates as they elevate their arm. Invariably the joint will relocate as the arm is brought down again.
This type of dislocation occurs because of joint laxity ('double jointedness') or muscle incoordination. Unlike recurrent dislocation of traumatic origin this type of instability responds poorly to surgery, which may make the situation worse. The mainstay of treatment of this particular type of shoulder instability is muscle re-patterning which can be done with physiotherapy.
|© J M Britton 2007|