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Chip On Your Shoulder Easy Dislocation

When it comes to dislocated joints, we take too much on our shoulders: almost ever other dislocation incident (45%), typically ski or motorcycle accidents, affects the joint where the upper arm connects to the shoulder bone. Sometimes the shoulder is hit with considerable force but most often the instinctively outstretched arm causes the problem while falling or tipping over. As one hits the ground, the abrupt force dislodges the head of the humerus (the upper arm bone) from the glenoid cavity. As little as throwing a ball can cause the same dislocation.

“The head of the humerus is a spherical joint, the most mobile of its kind in the human body,” explains Dr. Jenő Kiss, orthopaedic surgeon at Dr. Rose Private Hospital. “The payoff for this wide latitude of movement is a rather unstable joint with a shallow glenoid cavity, being held together by a tightly knit network of articular cartilage, tendons and muscles. Call it a design flaw, but this is a heavily accident prone joint, ready to dislocate from even relatively light force. Young, active males are most likely to suffer shoulder joint dislocation.”

The head of the humerus can dislocate in all directions, although ventral is the most common. The first thing to remember is a serious warning: diagnosis and therapy calls for a medical professional, as trying to relocate the joint might cause severe damage. The reason for this is that an X-ray is necessary to asses the exact direction of the dislocation and how much damage the surrounding tissues have suffered. Failing that, unskilled intervention might make things even worse, causing further sprain and strain of ligaments and muscles.

“X-ray will give us enough clues to decide if surgery is unavoidable or whether it’s enough to relocate the dislodged joint and stabilise it with a Desault’s bandage,” says Dr. Kiss. It takes at least three weeks for the dilated articular capsule and stretched muscles to contract and heal. Then physiotherapy can help strengthen those muscles, because once dislocated, a shoulder joint is likely to dislodge again, and the patient might end up with unavoidable surgery. Athletes often resort to surgery after the first incident, to avoid repeated sprains.”

Good to know

Shoulder joint dislocation being the result of some physical trauma, surgery is often the only solution. Depending on which direction the dislocation concerns, the aim of the surgical intervention is to create a buffer that stops the joint from dislocating again. Tightening the articular capsule and muscles or installing a bone stopper are viable solutions. Desault’s bandage locks the arm to the body for four weeks after the operation. Rehabilitation and physiotherapy work wonders on a damaged but healing joint.