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Glenohumeral Dislocation

When talking about a shoulder dislocation, usually it is an anterior glenohumeral dislocation that is referred to. Simply put, a shoulder dislocation is when the head of the humerus (the ball) pops out of the glenoid fossa (the socket). The shoulder is the most frequently dislocated joint in the body.

CAUSES: Usually a dislocation is caused by some sort of trauma such as a sports injury, a motor vehicle accident, or a fall.

SIGNS/SYMPTOMS: Sign and symptoms are fairly obvious with a visibly deformed or out of place shoulder, swelling, pain, and an inability to move the shoulder. Some less common symptoms may include tingling and numbness in the neck, shoulder, or arm.

DIAGNOSIS: History can tell a lot about the type of injury someone has sustained. With a suspected dislocation, certain orthopedic tests performed as well as palpation and visualization of the shoulder should render an accurate diagnosis. An x-ray can be performed to rule out fracture and visualize the dislocation. An MRI may be necessary to determine the extent of damage to the soft tissue surrounding the shoulder joint.

TREATMENT: When a dislocation is positively determined, a closed reduction is attempted. That means that the doctor tries to use a gentle maneuver to get the head of the humerus back into the socket. Sometimes swelling and pain prevent this from being successful so medications may be used to relax the muscles or sedate the patient. Once the dislocation is reduced, the severe pain should improve immediately. Following a reduction, immobilization for a period of time is necessary to allow for healing. Once it is deemed appropriate, rehabilitative exercises are necessary to strengthen the shoulder capsule and help restore range of motion. Surgery may be necessary if extensive soft tissue damage was done or if nerve or blood vessel damage occurred.

COMPLICATIONS: Ligament, tendon, or muscle tears surrounding the shoulder joint, damage to the nerve or blood vessels, and likelihood of future dislocations. Returning to activities too soon can lead to an increased likelihood of having repeat dislocations.

PROGNOSIS: With proper rehabilitation, an uncomplicated dislocation can get back to near normal. There is always a greater risk of reinjuring the shoulder once you have a dislocation though. 

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