This book describes Anterior Shoulder Dislocation, Diagnosis and Treatment and Related Diseases
Anterior Shoulder Dislocation
Shoulder Dislocation is a displacement within the shoulder joint
Injury and accidents can cause it away and at home
Some are due to the bone muscles overstretching
Others are due to the ligaments in the joint tearing
Males are affected more than female
Overexertion leads to many dislocations in males
There may severe pain and difficulty in activities
Some if untreated it may result in deformities
It is important the joint reduction is expedited
The blood supply to the joint may be compromised
Open dislocations may be treated by operation
Close dislocations required skills in reduction
X-rays will the confirm the severity
Severe dislocation may require surgery
Shoulder injuries can also be surgically stabilized
Followed by physiotherapy and exercise
-An original poem by Kenneth Kee
During one of the house call at night while working as a locum doctor for a group practice, I was able to reduce the dislocation of a Caucasian who had dislocated his shoulder while diving into the swimming pool.
I had read up about the procedure of reducing the dislocation of the shoulder before going for the house call.
Luckily the patient himself had recurrent dislocation before and so he knew how to help me reduce his dislocation.
I used a gentle steady straight traction on the arm with counter action on the shoulder pressing my foot in the armpit.
I then extended the Shoulder under traction to loosen the muscles
I next flexed the Shoulder slowly forward to reduce the dislocation and keep it immobilized at 90 degree of flexion in a sling for 1 to 2 weeks to allow for ligaments and capsular healing.
The next day he was to present himself to the clinic for an X ray to make sure the bone was securely in the socket.
The X-ray showed that the shoulder dislocation was successfully reduced without complication.
Anterior Dislocation of Shoulder is a frequent injury of the Shoulder.
It is the most frequent dislocation in the human body.
It is normally anterior in direction and results from a fall on the externally rotated abducted arm.
This forces the humerus out of the glenoid cavity of the shoulder blade into its anterior position.
Posterior dislocation is less frequent and may results from a force directed against the internally rotated arm.
Anterior dislocation is almost invariably traumatic.
It normally happens when people fall with a combination of abduction, extension and a posteriorly directed force on the arm
Symptoms:
Pain and deformity of the Shoulder
Acromial protrusion of the Shoulder joint
Absence of the normal fullness of the humeral head beneath the deltoid and acromial process
The doctor should assess radial nerve function: test for thumb, wrist and elbow weakness on extension and reduced sensation on the dorsum of the hand.
The rotator cuff is often damaged and should be examined after reduction.
Typically the other arm is holding on to the affected arm
With anterior dislocations the arm is held externally rotated, the shoulder is full and internal rotation is painful.
Typical signs are:
Apprehension Test
Relocation sign
Sulcus sign
The X-ray shows the humeral head lying under the coracoid process on the AP view
MRI test is useful for visualization of labral tear
Treatment
Muscle spasm tends to happen soon after dislocation and makes reduction more difficult
The doctor will push the ball of the upper arm bone (humerus) back into the joint socket in a closed reduction
Surgical repair increased shoulder stability and function.
Rehabilitation will begin with gentle muscle toning exercises