Shoulder Dislocation

Displacement of the humerus (upper-arm bone) from its socket in the shoulder joint. A forward displacement of the humerus is the most common type of shoulder dislocation.

Body Parts Involved

• Shoulder joint.
• Humerus.
• Soft tissue surrounding the dislocation, including nerves, tendons, ligaments, muscles, and blood vessels. Injury to nerves in the axilla (armpit) is quite common.

Causes

• Direct upward blow to the shoulder or backward force on an extended arm.
• End result of a severe shoulder sprain.
• Congenital abnormality, including shallow or malformed Joint surfaces.
• Powerful muscle twisting or a violent muscle, contraction. Some people can willfully produce a recurrent dislocation.

Signs & Symptoms

• Excruciating pain at the time of injury.
• Loss of function of the dislocated shoulder joint and severe pain when attempting to move it.
• Visible deformity if dislocated bones lock in the dislocated position. If they spontaneously reposition themselves, no deformity will be visible, but damage will be the same.
• Tenderness over the dislocation.
• Swelling and bruising at the injury site.
• Numbness or paralysis in the arm from pressure, pinching or cutting of blood vessels or nerves.

Treatment

Note:- Follow your doctor's instructions. These instructions are supplemental.

First Aid

• Keep the person warm with blankets to decrease the possibility of shock.
• Cut away clothing if possible, but don't move the injured area to remove clothing. Untrained should not attempt to reposition a dislocated shoulder.
• Immobilize the neck, dislocated shoulder, and elbow with padded splints or a sling.
• Follow instructions for R.I.C.E., the first letters of rest, ice, compression and elevation.
• The doctor will manipulate the dislocated bones to return them to their normal position. Manipulation should be done within 6 hours, if possible. After that time, internal bleeding and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and become difficult to return to a normal position. Relocating a dislocated shoulder frequently requires general anesthesia.

Continuing Care

At home:

• Use an ice pack 3 or 4 times a day. Wrap ice chips or cubes in a plastic bag, and wrap the bag in a moist towel. Place it over the injured
  area for 20 minutes at a time.
• After 48 hours, localized heat promotes healing by increasing blood circulation in the injured area. Use hot baths, showers, compresses, heat lamps, heating pads, heat ointments or liniments, or whirlpools.
• Exercise all muscle groups not immobilized in a cast or sling. Muscle contractions promote alignment and hasten healing.
• Massage gently and often to provide comfort and decrease swelling.

Medication

Your doctor may prescribe:

• General anesthesia or muscle relaxants to make joint manipulation possible.
• Acetaminophen to relieve moderate pain.
• Narcotic pain relievers for severe pain.
• Antibiotics to fight infection if surgery is necessary.

Home Diet

• Drink only water before manipulation or surgery to correct the dislocation. Solid food in your stomach makes vomiting while under general anesthesia more hazardous.
• During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Diagnostic Measures

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• X-rays of the shoulder joint and adjacent bones.

Prevention Tips

• Build your overall strength and muscle tone with a long-term conditioning program appropriate for your sport.
• Warm up adequately before physical activity.
• For participation in contact sports, protect shoulders with special equipment such as shoulder pads. After recovery, strapping or elastic wraps may protect against re-injury.