The shoulder has exceptional mobility which is quite advantageous, but makes the shoulder joint a common site of instability and dislocation. Often times shoulder subluxation or dislocation may be recurrent. The shoulder may be unstable anteriorly, posteriorly, inferiorly or multidirectionally. Initial anterior dislocations are most likely result of a fall, trauma, or forceful throwing motion. Once the joint becomes unstable the patient may feel as though the shoulder is slipping out of joint with certain movements and may be prone to recurrent dislocations.
After an acute dislocation is reduced the patient will likely be immobilized in a sling for 2-3 weeks. After a period of immobilization the patient will begin physical therapy to strengthen the rotator cuff muscles. Often times a MRI with contrast may be ordered to determine whether there was injury to the capsulolabral complex. Instability may be the result of soft tissue or a bony deficiency. In some cases of recurrent dislocation surgery may be necessary. A Bankart lesion is a tear of the labrum and detachment of the inferior glenohumeral ligament that results from an anterior-inferior dislocation of the humerus. Hill-Sachs lesions, impression fractures in the humeral head, often result from glenohumeral dislocations. The glenoid itself, the socket part of the joint, may also be fractured as a result of dislocation making it difficult to ensure stability by only addressing the soft tissues. In this case a Latarjet procedure may be necessary, which involves transferring autograft from the distal coracoid into the glenoid defect.
Shoulder instability is an issue that should be evaluated and treated, whether with conservative management, observation, or surgery. Our expert orthopedic surgeons will take the time to address your specific issues through clinical examination, appropriate testing, imaging, and follow up. If you have any questions or would like to schedule an appointment do not hesitate to call our office at 973-942-1315.
For further information on shoulder instability: http://orthoinfo.aaos.org/topic.cfm?topic=A00529
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