Dislocated shoulder
| Dislocated shoulder | |
|---|---|
| Anterior dislocation of the left shoulder. | |
| Specialty | Emergency medicine, orthopedics |
| Symptoms | Shoulder pain |
| Complications | Bankart lesion, Hill-Sachs lesion, rotator cuff tear, axillary nerve injury[1] |
| Types | Anterior, posterior, inferior, superior[2][1] |
| Causes | Fall onto an outstretched arm or the shoulder.[3] |
| Diagnostic method | Based on symptoms, X-rays[2] |
| Treatment | Shoulder reduction, arm sling[1][2] |
| Medication | Procedural sedation and analgesia, intraarticular lidocaine[4] |
| Prognosis | Recurrence common in young people[3] |
| Frequency | 24 per 100,000 per year (US)[1] |
A dislocated shoulder is a condition in which the head of the humerus is detached from the glenoid fossa.[2] Symptoms include shoulder pain and instability.[2] Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve.[1]
A shoulder dislocation often occurs as a result of a fall onto an outstretched arm or onto the shoulder.[3] Diagnosis is typically based on symptoms and confirmed by X-rays.[2] They are classified as anterior, posterior, inferior, and superior with most being anterior.[2][1]
Treatment is by shoulder reduction which may be accomplished by a number of techniques.[1] These include traction-countertraction, external rotation, scapular manipulation, and the Stimson technique.[1] After reduction X-rays are recommended for verification.[1] The arm may then be placed in a sling for a few weeks.[2] Surgery may be recommended in those with recurrent dislocations.[2]
Not all patients require surgery following a shoulder dislocation. There is moderate quality evidence that patients who receive physical therapy after an acute shoulder dislocation will not experience recurrent dislocations.[5] It has been shown that patients who do not receive surgery after a shoulder dislocation do not experience recurrent dislocations within two years of the initial injury.[5]
About 1.7% of people have a shoulder dislocation within their lifetime.[3] In the United States this is about 24 per 100,000 people per year.[1] They make up about half of major joint dislocations seen in emergency departments.[1] Males are affected more often than females.[1] Most shoulder dislocations occur as a result of sports injuries.[5]
- ^ a b c d e f g h i j k l Bonz J, Tinloy B (May 2015). "Emergency department evaluation and treatment of the shoulder and humerus". Emergency Medicine Clinics of North America. 33 (2): 297–310. doi:10.1016/j.emc.2014.12.004. PMID 25892723.
- ^ a b c d e f g h i "Dislocated Shoulder". OrthoInfo - AAOS. October 2007. Archived from the original on 17 June 2017. Retrieved 13 October 2017.
- ^ a b c d Cunningham NJ (2005). "Techniques for reduction of anteroinferior shoulder dislocation". Emergency Medicine Australasia. 17 (5–6): 463–71. doi:10.1111/j.1742-6723.2005.00778.x. PMID 16302939. S2CID 18146330.
- ^ Cite error: The named reference
Wak2011was invoked but never defined (see the help page). - ^ a b c Kavaja L, Lähdeoja T, Malmivaara A, Paavola M (December 2018). "Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis". British Journal of Sports Medicine. 52 (23): 1498–1506. doi:10.1136/bjsports-2017-098539. PMC 6241619. PMID 29936432.