Traumatic Shoulder Dislocation
What are the types/causes of shoulder dislocation?
The shoulder is the most commonly dislocated joint. This is probably because the shoulder is also the most mobile joint in the human body and to achieve this its socket is almost flat and the joint relies on soft tissues such as ligaments and muscles to maintain stability. There are 3 general types/causes of shoulder dislocation: traumatic (most common), atraumatic due to hyperlaxity, and muscle patterning (rare). Some patients may have subtle elements of more than one of these types/causes. Shoulder dislocations due to trauma and injury are most common and of these anterior shoulder dislocation is the most common (90%). Posterior dislocation is a rare form of traumatic dislocation often caused by seizure or electrocution.
In this video we discuss the causes and management of traumatic shoulder dislocations:
Do all shoulder dislocations need surgery?
Some dislocations are unable to be reduced in the emergency department and need an urgent general anaesthetic to put the shoulder back into joint. After this assessments need to be done to determine the cause and severity of the dislocation. Most atraumatic and muscle patterning dislocations do not require surgery and are best treated with physiotherapy. Most first time dislocations do not require surgery and they can be managed with physiotherapy, however recurrent dislocations may require surgery to stabilise the shoulder and prevent further damage.
Can my shoulder be stabilised with key-hole surgery?
Recurrent anterior dislocations may require surgery but the type of surgery needed depends on whether there is significant bone loss from the recurrent dislocations or whether the injury is purely a soft tissue one. If there is significant bone loss to the socket (glenoid) an open bony procedure may be required. If the injury is purely a soft tissue one, stabilisation may be performed with keyhole surgery using an arthroscopic anterior stabilisation.
What are the risks of arthroscopic anterior stabilisation?
It is important that before surgery you understand what is involved in the procedure and what to expect after the surgery. In this video we discuss the procedure of an arthroscopic anterior stabilisation, the post-operative rehabilitation, and risks of the procedure. In clinic prior to deciding on surgery we would discuss any risks that may be specific to you. On the day of surgery we then complete the consent process by discussing these risks again before you sign a consent form.
Click here to download my post-operative rehab protocol for your physiotherapist.
Our instructions for post-op care and recovery after shoulder surgery can be found here.