Shoulder Dislocation
Most people have heard or witnessed the incident of shoulder joint dislocation around them.
The shoulder joint is the most mobile joint in our body and naturally its dislocations are very common.
Shoulder dislocation occurs for 2 main reasons:
1. Shoulders arise with effects such as trauma falling, hitting or straining.
2. If there is imbalance in the shoulder ligaments, the shoulder joint works unstable and can come out with a simple movement.
Dislocations can also be seen in 2 ways:
Complete dislocation (shoulder head bone is fully removed from its socket),
Partial bone tip may not leave the joint socket completely.
We mostly see dislocations as a result of trauma.
What complaints occur when there is a dislocation?
Deformity
• pain - very severe for first time dislocations.
Swelling
• numbness
• weakening in strength
Bruising
If the shoulder that has been removed once has not received adequate treatment, it is easier to remove it a second time. Recurrent dislocations are very troublesome for joint cartilage. With each dislocation, the cartilages and ligaments around the joint are torn. Sometimes these tears are tears that cannot be healed later.
What is a bankart tear?
Bankart rupture is the rupture of the cartilage that surrounds the shoulder joint socket and shows a kind of vacuum effect like a gasket from the place where it adheres. It is difficult to stick to its place after this rupture. Recurrent shoulder dislocations begin to occur. In this case, this part should be stitched with arthroscopy instead.
What are the signs of a bankart tear?
Living with a feeling of dislocation in the shoulder
Recurrent dislocations that are increasingly easy
A feeling of snagging in the shoulder
Pain in the anterior part of the shoulder
What should be done after dislocation?
When there is a blow to the shoulder area, it takes experience to understand whether the deformity and swelling in the area is due to a dislocation or a fracture. Patients who experience their second or third dislocations now know what this feeling is, and if they have had enough licking, they can easily fit their joints themselves; They tell this as if it was a feat. Those who learn how much joint cartilage has been damaged now understand that they need to be operated after the second dislocation.
However, the pain of someone whose shoulder joint is removed for the first time is so severe that the patient may have difficulty believing the level of pain. In such a situation, the emergency service should be reached in the position it is in without moving the arm. It is also very easy to settle the dislocations that reach within the first half hour. As time passes, the spasm of the muscles around the joint increases and it becomes difficult to sit back; In fact, anesthesia is given to patients who are too delayed or whose muscle structure is very strong spasm to set the dislocation.
There are certain maneuvers while seating the shoulder joint, and if these are not applied correctly, cartilage injuries or even fractures may occur while the joint is seated. As soon as the surgeon realizes that a dislocation will not fit, he uses anesthesia method. Sometimes even under anesthesia, the dislocated joint may not sit; In this case, with open surgery, the dislocation is placed in its place and the torn structures are stitched.
Not all dislocated shoulder joints need surgery. After the dislocation, the joint is rested with a special shoulder arm sling for a short time and the pain is expected to pass and the torn structures to heal. Generally, when the edema passes, it is checked whether there is a tear that cannot be healed by performing an MR examination and examination around the 3rd week.
Physiotherapy is essential for strengthening and gaining range of motion in all dislocated shoulders, with or without surgery, to begin as soon as possible.
When surgery is required after dislocation, arthroscopic, or closed joint surgery techniques are mostly used to repair the torn or stretched structure. Open joint surgery is required for some rare injuries.
It is spoken that the so called bone-setters set the shoulder joint. Usually they call all types of shoulder injuries as 'dislocations' and say that they simply pull and snap into place. Their success seems to be high because they also claim that those joints as dislocated that are not actually dislocated. When real dislocations or fractures come, they do not want to touch these patients and send them to the hospital, or worse, they touch and increase the spasm and cause a delay. When dislocation occurs in elderly patients, forcing them to sit unconsciously can easily cause fractures.