
SHOULDER SURGERY

	SHOULDER ARTHROSCOPY ARTHROSCOPIC ACROMIOPLASTY ROTATOR CUFF REPAIR TOTAL SHOULDER REPLACEMENT TYPES OF SHOULDER SURGERY
SHOULDER CONDITIONS

	COMPARTMENT SYNDROME SHOULDER ARTHRITIS BURSITIS OF THE SHOULDER SHOULDER TENDONITIS ERB'S PALSY FROZEN SHOULDER SHOULDER FRACTURES ROTATOR CUFF TENDONITIS SHOULDER IMPINGEMENT SHOULDER SPRAINS & STRAINS SHOULDER DISLOCATION
PATIENT RESOURCES

	FREQUENTLY ASKED QUESTIONS BEFORE SHOULDER SURGERY AFTER SHOULDER SURGERY ANATOMY OF THE SHOULDER SHOULDER SURGERY GLOSSARY

Shoulder Dislocation

What is shoulder dislocation?

If your shoulder is wrenched upward and backward, you may dislocate it out of its socket. This condition is both painful and incapacitating. The force required is often that of a fall or a collision with another person or object (both of which can occur during many sports).

Most shoulder dislocations happen at the lower front of the shoulder, because of the particular anatomy of the shoulder joint. The bones of the shoulder are the socket of the shoulder blade (scapula) and the ball at the upper end of the arm bone (humerus). The socket on the shoulder blade is fairly shallow, but a lip or rim of cartilage makes it deeper. The joint is supported on all sides by ligaments called the joint capsule, and the whole thing is covered by the rotator cuff. The rotator cuff is made up of four tendons attached to muscles that start on the scapula and end on the upper humerus. They reinforce the shoulder joint from above, in front, and in back, which makes the weakest point in the rotator cuff in the lower front.

Subluxation refers to a partial dislocation. A subluxation occurs when the two joint (articular) surfaces have lost their usual contact. A 50% subluxation means the normally opposing articular surfaces have lost half their usual contact and the joint is partially dislocated. A 100% subluxation means the articular surfaces have lost all of their contact. A dislocation is the same as a 100% subluxation.

What causes shoulder dislocation?

The shoulder joint is the most frequently dislocated joint of the body. Because it can move in many directions, your shoulder can dislocate forward, backward or downward, completely or partially. In addition, fibrous tissue that joins the bones of your shoulder (ligaments) can be stretched or torn, often complicating the dislocation.
When your shoulder dislocates, a strong force, such as a sudden blow to your shoulder, pulls the bones in your shoulder out of place (dislocation). Extreme rotation of your shoulder joint can pop the ball of your upper arm bone (humerus) out of your shoulder socket (glenoid), which is part of your shoulder blade (scapula). Partial dislocation (subluxation) — in which your upper arm bone is partially in and partially out of your shoulder socket — also may occur.

A dislocated shoulder may be caused by:

Sports injuries. Shoulder dislocation is a common injury in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing, gymnastics and volleyball.
Trauma not related to sports. A hard blow to your shoulder during a motor vehicle accident is a common source of dislocation.
Falls. You may dislocate your shoulder during a fall, such as from a ladder or from tripping on a loose rug.

Shoulder dislocation symptoms:

Patients with a shoulder dislocation are usually in significant pain. They know something is wrong, but may not know they have sustained a shoulder dislocation. Symptoms of shoulder dislocation include:

Shoulder pain
- Arm held at the side, usually slightly away from the body with the forearm turned outward
Loss of the normal rounded contour of the deltoid muscle

Diagnosing Shoulder Dislocation:

Diagnosis of a shoulder dislocation is usually quite apparent just by talking to a patient and examining their joint. Patients must be examined to determine if there is any nerve or blood vessel damage. This should be done prior to reduction (repositioning) of the shoulder dislocation. X-rays should be obtained to check for any fracture around the joint, and to determine the pattern of the shoulder dislocation.

Shoulder Dislocation Surgery:

Surgery is sometimes necessary following a shoulder dislocation if there has been extensive damage to muscles, tendons, nerves, blood vessels or the labrum. Surgery is then usually performed as soon as possible after the injury.

In cases of recurrent shoulder dislocations, surgery may be offered in an attempt to stabilise the joint. There are a number of procedures which can be performed. The decision over which procedure to use depends largely on the patients lifestyle and activity. Some procedures result in reduced shoulder external rotation and so are not suitable for athletes involved in throwing or racket sports as this would affect performance.