Prognosis
Young, athletic patients in particular are frequently affected by recurrences. Up to 60% suffer further habitual dislocations after a traumatic dislocation. After the operation, dislocated shoulders rarely (5%) reoccur.
Under certain circumstances, a shoulder dislocation can also lead to injury to the capsule, ligaments and tendons of the shoulder joint. Often the glenoid rim of the joint is also damaged, this is called a Bankart lesion. Recurrences, i.e. the recurrence of shoulder dislocations even with minor injuries or everyday movements, occur in over 50% of cases. Surgery may be necessary here. A shoulder dislocation increases the risk of osteoarthritis in the shoulder joint, which mainly affects older patients.A shoulder dislocation should be treated medically and physiotherapeutically to avoid permanent movement restrictions.
Dislocated shoulder in the child
In children with shoulder dislocation, a distinction must be made between traumatic or post-traumatic and habitual causes. Habitual is used to describe dislocations that were not preceded by trauma or an accident. The children can dislocate their shoulder with simple everyday movements.
In this case, surgical fixation is recommended to prevent long-term damage. In the case of dislocations that recur after a trauma or that have left behind damage to the cartilage, arthroscopic surgery is recommended to secure the shoulder ventrally (anteriorly). However, operations on the bone should be avoided here because of the still open growth joints. Adequate physiotherapy must then be provided to strengthen the shoulder muscles.
Anatomical basics
The glenohumeral joint is formed by the head of the humerus (joint head), which lies in the glenoid cavity (part of the shoulder blade). The stability of the shoulder joint is mainly provided by muscles and ligaments. The muscles of the rotator cuff in particular play a decisive role here. However, since the joint head is 3 times larger than the glenoid cavity and there is no bony guidance of the shoulder joint, shoulder dislocation is promoted. At the same time, however, this is the basis for the large range of motion in the shoulder joint.
