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Shoulder dislocation

Optimal treatment of shoulder dislocations

Occasionally, an accident, fall, or other injury to the shoulder results not in a fracture but in spontaneous slippage of the humeral head out of the socket. This slippage is not only extremely painful and associated with limitations in mobility, but also poses a great risk of further injury. In the case of shoulder dislocation, the first thing to do is to have urgent reduction of the humeral head performed by a specialist in the emergency room or by a specialist.

The rapid examination provides information on whether further damage has occurred to the tendons, ligaments or joint cartilage as part of the so-called shoulder dislocation. Prompt treatment, in turn, reduces the risk of long-term or permanent damage to the shoulder.

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Orthopädie Zentrum München Ost - Schulter - Erkrankungen

Table of Contents:

What is a shoulder dislocation?

Causes of shoulder dislocation
Symptoms of shoulder dislocation
Diagnostics & therapy for shoulder dislocations
Treatment of shoulder dislocation at the Orthopaedic Center Munich East (OZMO)

What is a shoulder dislocation?

Shoulder injuries are primarily differentiated according to the type of accident. The direct impact trauma to the shoulder often results in an injury to the acromioclavicular joint. This results in an elevation of the clavicle, also known as piano key phenomenon. The injuries are very painful and are divided into several stages. They can often be treated well conservatively even in older patients.

However, if a fall occurs on the outstretched arm or when the body is caught over the arm, shoulder dislocations often occur due to the leverage effect. Dislocation of the head of the shoulder joint occurs, but depending on the situation, it cannot find the correct position on its own. The medical term for the dislocation of the humeral head from the socket is called shoulder dislocation.

Shoulder dislocation can be recognized by the fact that the shoulder is often absolutely painful and immobile from this point on. Sometimes there is a “tingling” sensation in the arm or numbness if the nerve pathways are damaged or even torn. Mobility is severely limited and can only be done minimally with pain. The shoulder must then be reduced in the emergency room, with appropriate pain therapy, which means that the slipped part of the shoulder must be straightened back into its natural position.

Causes of shoulder dislocation

If leverage is applied to the arm in an accident or to break a fall, the stability of the shoulder and rotator cuff cannot always withstand this stress. The condyle slips out of the socket and is not held in place with equal strength by tendons and muscles, which are affected differently by the stress of the incident. As a result, the condyle gets into a faulty position that the affected patient cannot correct on his or her own and/or with great pain.

Since the return of the condyle to the socket is again a large load that can cause further damage, the setting of a shoulder dislocation should only be performed by a physician. Until personal contact with the doctor, the dislocated shoulder should be cooled.

Symptoms of shoulder dislocation

In shoulder dislocation, severe pain and severe limitation of arm mobility occur immediately following the triggering incident. The shape of the shoulder shows changes depending on the severity of the shoulder dislocation. Swelling and bruising can form after only a short time. At the same time, tingling sensations or numbness sometimes occur in the arm and fingers.

Shoulder dislocation often results in concomitant injuries with cartilage damage. But a tear of the joint lip, also called labrum, can also occur. This joint lip or labrum has a function like a sealing ring and, like a brake block, ensures that the humeral head does not slip out of the socket. If this sealing ring is appropriately displaced by the accident or a shoulder dislocation, there is a risk that it will heal in an incorrect position. Healing in an incorrect position can in turn lead to chronic instability of the shoulder, which causes a shoulder that keeps popping out even during everyday movements.

Diagnostics & therapy for shoulder dislocations

Diagnosis begins with a physical examination, during which a physician can often already feel the malposition of the joint head and the empty socket. This is followed by sonography and, if necessary, an X-ray, but most importantly, an MRI is performed to determine the extent of the damage. The existing damage is decisive for further treatment and the decision for conservative or surgical therapy.

Once the actual situation of the shoulder joint is known, the experienced specialist can say whether closed reduction (setting the shoulder, usually with the administration of painkillers, anesthesia or anesthesia) or surgical treatment is necessary. During surgery, the doctor may also tighten the overstretched ligaments, if necessary, to minimize the risk for recurrent dislocation. If necessary, immobilization of the joint with a special bandage may be necessary in order to start physiotherapeutic treatments after four to six weeks.

Especially in young patients, surgery may be necessary if the joint lip is displaced as a “sealing ring”. This involves arthroscopic outpatient keyhole surgery to reattach the shoulder joint to the socket. If the seal ring is not displaced in its position, conservative therapy may also be sufficient to aid recovery from shoulder dislocation. Regular strengthening and coordination training in the shoulder area should also become a preventive measure after healing in order to rule out the possibility of the shoulder dislocating again.

Treatment of shoulder dislocation at the Orthopaedic Center Munich East (OZMO)

If you have suffered a shoulder dislocation and need competent support, you will find an accomplished team of specialists for customized orthopedic treatments at the Orthopädie Zentrum München Ost (OZMO). We start where you are right now: Whether it’s from the setback immediately following the incident or in the follow-up care you need after your visit to the emergency room. We offer comprehensive examinations and modern therapies from a single source. Our specialized doctors are supported by a competent practice team who will be happy to book you an appointment in our well-equipped practice.

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