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The shoulder is a ball and socket joint in which the humerus head is the ball and the glenoid cavity is the socket. The glenoid cavity is reinforced by a thickened layer of capsule called the labrum, which causes the deepening of the glenoid socket. In extremes of shoulder position or movement, abnormal forces will cause the humerus head to slip out of the cavity which is called a shoulder dislocation. If the shoulder dislocation happens more than one time, it is called recurrent shoulder dislocation
Pain that is very severe in nature, restricted shoulder movements along with deformity of the shoulder are seen in shoulder dislocation.
An episode of shoulder dislocation will warrant a visit to the hospital due to severe pain. After assessment of the shoulder, confirmation is obtained by an X-ray which can also show if there is an associated fracture. Once a shoulder dislocation is confirmed, your doctor will attempt to reduce the dislocation using specific techniques using mild sedation. In patients whose dislocation cannot be reduced by mild sedation, anesthesia may be required and dislocation reduced in the operation theatre.
The patient’s arm is immobilized for 2 weeks using a shoulder immobilizer and ice fomentation, analgesics are given to reduce pain. Gradual shoulder movements are encouraged later after the patient becomes comfortable.
However, in patients who have a chip fracture of the glenoid called a bony Bankart’s lesion, immediate surgery is recommended since these patients have a high chance of redislocation immediately.
Nearly 95 % of patients less than 25 years with first-time shoulder dislocation have a chance of recurrent dislocation. If patients experience a second episode of dislocation, after the reduction of dislocation they are investigated with an MRI to find our the lesion which shows a labral tear called Bankarts tear along with a defect in the humeral head called Hill Sachs defect. Once the lesion is confirmed, patients are counseled about the option of surgery.
Patients with recurrent shoulder surgery can undergo conventional open surgery or the latest technique of arthroscopy (Key Hole Surgery) depending on the cause of the lesion and nature of the tissue