Shoulder Dislocations ,Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describing conditions and treatment associated with shoulder dislocations, the etiology, signs and symptoms, and the prognosis.
For the purpose of shoulder stability, the labrum acts like a bumper within the joint capsule of the shoulder joint. The axillary nerve is most commonly involved in injuries associated with the shoulder joint. It arises from the posterior cord of the brachial plexus and supplies the teres minor and deltoid muscles as well as the skin of the shoulder.
Injury to the axillary nerve will result in
•Numbness in the shoulder area
•Weakness of shoulder abduction
The shoulder joint is the most commonly dislocated joint in the body
Types of shoulder dislocation
1-Anterior dislocation
2-Posterior dislocation
Anterior dislocation
Anterior dislocation is seen in more than 95% of cases involving shoulder dislocation.
The mechanism of injury related to anterior shoulder dislocation is usually indirect force with a combination of abduction, extension and external rotation. It occurs with the arm in a position away from the body, often overhead, with the arm rotated backward.
Anterior dislocation is often found with a combination of labral tear, greater tuberosity fractures or fractures of the humeral head.
Bankart lesion
•Refers to a tear of the anterior-inferior labrum of the glenoid rim.
•Bankart lesions may be associated with a high recurrence rate of dislocation in patients younger than 30 years of age.
•Bankart lesions occur either as fibrous or osseous.
In elderly patients, dislocation of the shoulder is often associated with rotator cuff tears.
The head of the humerus may impact against the anterior-inferior edge of the glenoid causing a divot or flattening of the humeral head.
Treatment of anterior dislocation
•Immediate reduction
•Dislocation is ruled out if the patient can touch the opposite shoulder.
•Immobilization of shoulder dislocations remains a controversial topic in duration and position of the immobilization.
Unable to lift the arm after reduction of shoulder dislocation:
•Young patient think axillary nerve palsy
•Elderly patient think rotator cuff tear.
Surgery is usually reserved for patients with recurrent instability.
Posterior dislocation
•Usually associated with seizures or electric shock and is often missed on radiographs.
•With posterior shoulder dislocation, there is a lack of external rotation movement of the shoulder joint.
•Posterior dislocation will dislocate straight posterior. Only 5% of shoulder dislocations are posterior.
•Normal external rotation of the shoulder is possible without the presence of posterior dislocation.
•The most reliable sign of posterior dislocation is the presence of the shoulder being locked in internal rotation.
•Reverse bankart lesion, reverse hill-Sachs fracture or lesser tuberosity fractures of the humeral head may also accompany a posterior dislocation.
•Axillary radiograph view is used to diagnose posterior shoulder dislocation.
•The humeral head is seen impacted onto the posterior rim of the glenoid.
Inferior subluxation of the shoulder
•Often confused with shoulder joint dislocation.
•Axially radiographic view is normal in these cases.
•Inferior subluxation is caused by:
Deltoid muscle atony
•muscle of the shoulder has lost its strength to maintain the position of the humeral head within the joint.
Treatment is given by physical therapy and electrical stimulation.

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