Shoulder dislocation The shoulder is the most commonly dislocated large joint in the human body The commonest dislocation is anterior or subcoracoid Reasons for Dislocation There are two main reasons for dislocation, incoordinate muscle contraction and lax joints (atraumatic dislocation) Or an injury causing the joint to dislocate (traumatic) The damage done in an injury depends on severity of the injury but also the age of patient, in general, Those under the age of 21 have a high incidence of recurrent dislocation. Those over 45 have a much lower risk of recurrent dislocation. This directs treatment options toward Operative or non operative techniques TreatmentsI Bankarts Repair When the shoulder dislocates it may tear off the Labrum (a kind of cartliage that deepens the joint ) this may then lead to feelings of pain and instability or may lead to recurrent dislocations. This can be diagnosed by a good history and examination but may require an MRI scan to confirm the damage An arthroscopic repair can be performed as a Day Case procedure. This involves inserting several anchors into the bone at the front of the shoulder so that the labrum can be tied back into place. Following this it is essential that time and physiotherapy are given to ensure the best result Time off work It is likely that overhead activities will not be suitable for at least 6 months Driving is likely to recommence 6 weeks after surgery Heavy lifting should recommence 6 months after repair Failure rates reports vary from about 5% to 15%. some activities, such as going back to playing Rugby, are known to have amonst the highest failure rates
Open Repair If the labrum is badly damaged or the bone at the front of the shoulder has also been damaged then an open repair such as a Laterjet repair may be thought suitable. This involves using a piece of bone at the front of the shoulder called the coracoid and fixxing it where the labrum used to be
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