The shoulder joint, which is the most mobile joint in our body, is the structure that provides the union of the shoulder blade and arm bone and helps the joint capsule and short tendons stay together. For this reason, it provides us with ease in movement, but it also increases the risk of dislocation. Since the shoulder joint is one of the joints we use most to protect our body, it is frequently injured. This is a disorder that can be observed at almost any age. Shoulder dislocations are generally seen with fractures, vascular and nerve injuries.
What are the Symptoms of Dislocation of the Shoulder?
Shoulder dislocations, which usually occur as a result of trauma, are quite painful. The most common symptoms:
- Severe pain in and around the shoulder,
- The patient's inability to clearly use his arm (even carrying his arm with the other hand),
- Symmetry in the image of the shoulder joint area /deformity.
Then Magnetic Resonance (MR) should be taken. In this way, if there are bone and soft tissue injuries, ligament, tendon and labrum injuries that occur with shoulder dislocation, these are also detected.
How to Treat Shoulder Dislocation?
Non-surgical treatment of shoulder dislocation consists of repositioning with certain maneuvers, if the dislocation is appropriate. After determining the direction of shoulder dislocation, it can be placed in place with certain maneuvers. This procedure is called “shoulder dislocation reduction”.
Before the reduction, the patient is given drugs that relax and soothe the shoulder muscles, then the dislocated shoulder is placed in place with maneuvers. When the shoulder is placed in its place, the pain caused by the dislocation disappears and the patient is relieved.
After the placement, a control x-ray is taken and the location of the shoulder is observed. Afterwards, shoulder dislocation bandage, shoulder dislocation splint or shoulder pads used for shoulder dislocation are used to keep the shoulder motionless.
How Long Does It Take to Heal After Dislocation of the Shoulder?
2 weeks after the dislocation is treated with or without surgery, the patients have no pain in the shoulder joint. It is evaluated by the physician again in terms of joint limitation.
Usually, 2-3 weeks after reduction, the shoulder braces can be removed and the patient is given mild physical therapy movements with limited range of motion. The recovery period is about 4-6 weeks with the help of a physiotherapist. Since the patient may have pain during the physical therapy process, painkillers or muscle relaxants may be given to the patient. They may need help with their daily activities for a period of 1 month after the surgery.
Does Dislocation of the Shoulder Recur?
Shoulder dislocations are a condition that has a recurring probability depending on the age at which the shoulder first appeared. If your shoulder first came out at the age of 18-20, 80% will come out again. If your shoulder has dislocated for the first time in the age range of 20-40, this rate drops to 60%. If you are 40 years of age or older and your shoulder has been dislocated for the first time, tears in your "rotator cuff" muscle group are usually seen with this shoulder dislocation.
Why Does Dislocation of the Shoulder Recur?
At the same time, many ligaments connecting your shoulder are damaged when the shoulder is dislocated. For this reason, these ligaments cannot heal as the dislocation recurs. In addition, recurrent dislocations cause loss of bone structure in the shoulder socket. As a result, dislocations recur.
How to Treat a Dislocation of the Shoulder with Surgery?
Some shoulder dislocations are treated with surgery. Generally, surgical treatment in shoulder dislocations is preferred to prevent recurrent dislocations. In people with shoulder dislocation,
There are two methods of surgical treatment, open and closed. Open surgery is considered the gold standard in the language of medicine, but with the advancement of medicine, closed surgeries (arthroscopic surgery) by entering into the shoulder through a few holes are now with similar success rates. If there is severe bone loss in individuals with shoulder dislocation, bone block operations (laterjet) should be applied. Thanks to this surgery, a small piece of bone that prevents the shoulder from protruding forward is placed in the area. As in any surgery, the success of the surgery varies according to the age of the patient, the number of dislocations, the dislocation mechanism and the bone structure of the shoulder.
Why Physiotherapy Is Performed After Shoulder Dislocation Surgery?
With the surgery, your shoulder regains its stability and adequate range of motion and functions are regained without dislocation. After the treatment of shoulder dislocation after the operation, a shoulder strap is used for a certain period of time. For this reason, physical therapy should be continued in the presence of a physiotherapist in order to regulate the movement of the arm and shoulder. Thanks to the combined treatment of physical therapy and surgery, sports and daily activities can be returned as soon as possible.
What is Shoulder Arthroscopy?
Thanks to the arthroscopy method, the inside of the shoulder joint can be seen through small incisions and closed surgery can be performed here. A thin, long and illuminated instrument called an arthroscope is used for this surgery and imaging procedure. Thanks to this device called arthroscope during the surgery, live video images taken from inside the joint can be seen on the screen. In this way, problems in the shoulder can be easily detected and treated. Since very small incisions are made with this surgery, the recovery period of the patient after the surgery will be less painful and shorter compared to the open surgery.
What are the Risks and Complications of Shoulder Arthroscopy?
- Shoulder stiffness and constant pain,
- Bleeding or blood clot ,
- Infection,
- Nerve or vessel damage.
Impingement
It is a health problem that occurs when the arm is used above the head for a long time. As a result, if the patient moves his arm, it may cause the patient to experience pain and problems. This compression problem in the patient can also cause bursitis or tendinitis. Bursa (search for moving parts) The fluid-filled sac (which helps reduce friction in the skin) may swell and thicken. For this reason, the bursa can be removed with surgery, or if the acromion protrusion is formed, it can be shaved or the coracoacromial ligament can be cut so that the patient can move more easily.
Rotator Cuff Tear
The part called rotator cuff can be torn as a result of sudden injury or overuse. This tear may cause complaints such as pain, weakness in the arm and loss of normal shoulder movements in the patient. Thanks to the surgery, the torn parts of the torn rotator cuff tendons of the patient are removed and the beams are attached to the arm bone. Anchors, sutures or surgical screws are used for this.
Capsule Stretching
The stretching of the capsule causes the capsule to loosen, causing the joint not to stay firmly in place. It can disturb individuals by creating a feeling as if the bones in the joint are moving too much with movement. With arthroscopy, the stretched capsule is folded inward and sutured, so that the capsule becomes taut again. In this way, the shoulder joint becomes stronger.
Tear of Labrum
The labrum is torn at the edge of the glenoid socket, creating a feeling of being stuck or dislodged in the joint. In fact, the shoulder can actually dislocate. The torn labrum is repaired by attaching special anchors to the glenoid socket and then securing it with sutures. After these procedures, the joint is now more robust.
Arthritis and Free Bodies
The damage caused by excessive use and increasing age in the articular cartilage is called arthritis. This discomfort can also occur as a result of rheumatic diseases or injuries. As there is wear, some free bodies or bone protrusions may occur in the bone or cartilage tissues inside the joint. These protrusions are cleaned with surgery and the rough appearance of the joint is corrected. Free bodies, if any, can be removed surgically. Also, bone can be scraped or filed to help new cartilage form.
Can You Do Sports After Dislocation of the Shoulder? When Can You Start Sports?
In order not to lose the mobility of the shoulder joint, it is started to be exercised with light exercises immediately after the treatment.
- When the rehabilitation process is completed, contact sp for up to 6 months Staying away from places,
- Stoping the exercises as soon as they trigger pain or pain,
- The regular implementation of the exercise program every day,
- Using shoulder protectors while doing sports,
- It is recommended to take precautions against traumas, especially when sudden hand and arm movements such as falling will be used.
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