Luxation of the shoulder – causes, symptoms and treatment

Shoulder dislocation is also colloquially referred to as ‘a dislocated shoulder’. The shoulder joint consists of a bowl and a socket that can be pulled apart in the event of trauma, sports injury or due to an overly flexible attachment of the tendons and muscles. It is important to take immediate action and go to the emergency room. In this way, further damage can be prevented. The causes, symptoms and treatment of shoulder dislocation are described further.

What is a shoulder dislocation?

With a shoulder dislocation, the head of the humerus is no longer in the socket. There are two other forms of shoulder dislocation in which one of the shoulder joints dislocates, but we limit ourselves here to dislocating the humerus.

Anterior luxation

With a shoulder dislocation, the humeral head can shoot forward and remain in that place. It is one of the most common forms of luxation. When observing the shoulder, a clear deformity of the shoulder joint can be observed. A swelling can be seen at the front. The patient complains of a lot of pain, even when resting, and cannot move the arm. An X-ray examination can confirm the diagnosis and also detect possible other damage. Blood flow and nerve supply should also be checked.

Posterior luxation

A posterior luxation occurs less frequently and the head is displaced posteriorly. This is more common in people over 40 years of age. This mainly occurs with a blow from the front, such as a fall with outstretched arms. Thanks to the muscle action, the humeral head is pulled backwards. This muscle action can occur due to epilepsy, coma caused by problems with diabetes. A direct fall rarely causes a posterior dislocation, it is usually in combination with muscle action. Because the injury can last for months to years, the diagnosis is sometimes overlooked and people continue to worry about it for a long time. There is slight swelling behind the shoulder and the patient has difficulty moving the arm away from his body.

Spontaneous luxation

In some people, the attachment is too mobile and the shoulder spontaneously dislocates. The attachment is then too weak and the entire shoulder joint has become unstable. Also on the other side of the body. The shoulder can sometimes also be dislocated spontaneously or with a wrong movement.

What are the consequences of shoulder dislocation?

A forward luxation can be accompanied by a tear in the tendon cap (rotator cuff) or a tear in the joint surface (labral tear). We mainly notice the rotator cuff in people over 50 years old because their tendons have become weaker over the years. In younger people, a Bankart injury and/or a Hill-Sachs injury occurs more often. With a Bankart injury there is an abrasion of the anterior part of the meniscus and the anterior part of the capsule. A Hill-Sachs injury involves a dent in the humeral head.

What is the treatment for a shoulder dislocation?

The intention is for the shoulder to be straightened as quickly as possible. This can happen spontaneously or by placing the shoulder. This is usually done under local anesthesia, but can also be done under general anesthesia if the treatment requires it. Which method is used depends on the luxation.
During surgery , the shoulder is put back into the correct position under general anesthesia. Afterwards, the shoulder should not be moved for 3 weeks. After these weeks, you may, with the doctor’s permission, place light weight on the shoulder. This is done under the supervision of a physiotherapist who will draw up a training schedule together with the patient. If the agreements are not adhered to and the shoulder is loaded too quickly, there is a chance that a dislocation will occur again. In people under the age of 20, there is an 80% chance that the shoulder will dislocate again within 2 years. There is also a risk of osteoarthritis later in life at the place where the dislocation occurred.

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