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Shoulder Dislocation

The document provides an overview of shoulder dislocation, including its causes, types, clinical features, investigations, treatment options, and rehabilitation phases. It details the different types of dislocations, particularly emphasizing anterior dislocations, and outlines conservative and surgical treatment methods. The rehabilitation process is divided into phases, focusing on gradual recovery and strengthening exercises.

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2 views27 pages

Shoulder Dislocation

The document provides an overview of shoulder dislocation, including its causes, types, clinical features, investigations, treatment options, and rehabilitation phases. It details the different types of dislocations, particularly emphasizing anterior dislocations, and outlines conservative and surgical treatment methods. The rehabilitation process is divided into phases, focusing on gradual recovery and strengthening exercises.

Uploaded by

ashwinpatil489
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Shoulder Dislocation

Index
•Causes
•Types
•Clinical features
•Investigation
•Treatment
•Physiotherapy

Dr Ravi
Shoulder Dislocation
• Subluxation refers to a partial dislocation.
• Inj to Glenoid labrum below the center anterior (front) of the
socket, this is called a Bankart lesion
Types
 (98%) are anterior dislocations

 4% Posterior shoulder dislocations

 inferior glenohumeral dislocation (Luxatio erecta)

4 types of anterior shoulder dislocations


• Subcoracoid
• Subglenoid
• Subclavicular
• Intrathoracic
Glenoid labrum
• fall or a collision with another person
• Traumatic injury, such as a fall, sports injury,
or car accident
• Overuse/repetitive strain: -tennis, golf,
swimming, volleyball
• Loose capsular ligaments: injury or overuse,
or from previous shoulder dislocations
• Multi-directional instability: this is a genetic
predisposition that causes a shoulder to be
unstable
• Electric shock
• Direct blow on Ant shoulder : Post Disloc
• Epileptic attack
• Falling from tree with arm in abduction and
elevation : the head of the humerus is pushed
downwards underneath the Glenoid and arm
is held in abduction and elevation : Luxatio
Erecta
Clinical feature
• Severe pain
• Numbness, tingling, and weakness may occur
in the affected upper arm.
• Deformity
• Swelling
• Numbness
• Instability and Weakness
• Bruising
• Dec ROM
Invg
• MRI
• X ray
Treatment
Conservative :
MUA (Ant Disloc): strapping with arm to chest for 3
weeks

MUA(Post Disloc): Sling 3 weeks

Surgery :
• Arthroscopy surgery: labrum repair
• Open surgery
Complication
• Subcoracoid dislocation: axillary nr damage
• Recurrent Ant Disloc of shoulder
• Inj to RC
• Supra spinous tendinitis
Rehabilitation
REHABILITATION
Phase I: 1-3 Weeks
Avoid 90 d Abd and external rotation (Ant Dis)
Avoid IR in case of (Post Disloc)
• pain killers
• cryotherapy
• sling
• shoulder flexion and abduction in the sling
• Isometric for deltoid, biceps and triceps
Phase II : 4-6 weeks
•Hot fomentation
•TENS
•FES for Deltoid (for axillary nerve palsy)
•Static shoulder strengthening ex continued
• Codmans ex
• Relaxed Passive abduction with arm in int Rot: 45 d
• Wand exs
• PRE
• Achieve 90% of ROM by 6-8 wks
• Resistive training and Stretching for and forced ER-12 wks
• 20 rep and 3 times/day Hold time 3-5 seconds
Phase III (8-12 weeks )
Recurrent Ant Disloc of shoulder
or
traumatic Unidirectional Bankart lesion (TUBS)
Causes
• Unhealed avulsed ant capsule
• In adequate RX or Immobilization
• Arm Ext Rot and Abduction dressing/ playing
• Bankart Lesion: traumatic avulsion of G
Labrum+ Ant Capsule
• Hill Sachs Lesion : defect in the post lat
quadrant of the head of the humerus
Clinical features
• Usually patient reduces the disloc himself
• Apprehension sign + ve : patient resists movt
of ext rot and abduction due to pain

Treatment
• Arthoscopic Surgery: Bankart operation: Ant
capsule and G labrum is reattached.
• Latarjet procedure
• Putti Platt operation

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