Shoulder Luxation
Shoulder dislocation is a dislocation of the shoulder joint. The head of the humerus no longer sits in the glenoid cavity, but has slipped out. In shoulder dislocation, one can distinguish between traumatic and habitual forms.
Traumatic shoulder dislocation is caused by direct force (usually on the outstretched arm), which causes the humerus to be levered out of its position, e.g. when absorbing a fall. The habitual shoulder dislocation occurs without prior trauma and is considered to be congenital, e.g. due to congenital disorders in the capsule-ligament apparatus of the shoulder, muscular malformations or deformations of the shoulder joint, which makes it less stable and consequently more easily dislocated. Symptoms: Depending on the direction in which the humerus slips, different types of shoulder dislocation are described.
At 90%, the anterior shoulder dislocation is the most common. The affected arm is turned outwards and spread away from the body. The head of the humerus no longer sits in the socket, but has slipped down towards the front.
The affected arm is usually held by the patient with the healthy arm. The shoulder dislocation is also very painful.Diagnosis: In most cases it can already be determined externally that it is a shoulder dislocation. The doctor can usually already see and feel that the humerus is no longer in its correct position.
In order to rule out injury to bones or ligaments, an X-ray and an MRI can be helpful. Therapy: The humerus must be returned to its original position. This process is called reduction.
Since this can be very painful for the patient, adequate pain therapy must be ensured. Sometimes a short anaesthetic may be necessary for the reduction. At the scene of the accident, the patient should first be cooled and the arm held still.
The arm can only be reduced after an X-ray has been taken. A blind attempt at reduction is associated with the risk of overlooking a fracture and injuring vessels, nerves and soft tissue. After reduction, the arm should be spared for some time.
In addition, subsequent physiotherapeutic treatment is often indicated to restore full function. Depending on the extent of the slippage, treatment can be lengthy until full recovery of function and mobility. The so-called frozen shoulder (also: painful shoulder stiffness) is a painful restriction of movement in the shoulder joint.
Often the function in the affected joint is completely lost. Frozen shoulder usually occurs in people between the ages of 40 and 60, and in a third of patients, on both sides. Men and women are equally affected by the disease.
The exact causes that lead to the development of frozen shoulder have not been clarified. However, it can also occur in the context of previous shoulder injuries, e.g. after injuries to the rotator cuff, bursitis or at the base of an arthrotic shoulder joint alteration. Therapy: Therapy is mainly carried out by administering anti-inflammatory and analgesic medication, as well as intensive physiotherapy.
This is intended to keep the shoulder as mobile as possible. Sometimes mobilization of the shoulder joint under anesthesia is indicated, whereby the stiffened joint is moved powerfully against the stiffening. An incision of the joint capsule can also help to improve the symptoms.
