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Op. Dr. Tolga Mertoğlu

SHOULDER DISLOCATION

Shoulder dislocation is a disorder that can often be observed in the shoulder, the most mobile joint in the body. These dislocations, which can be observed for various reasons, mostly occur due to traumas. In traumatic dislocations, dislocation occurs towards the anterior or posterior direction. Anterior dislocation is observed in 96 percent of the patients. The risk of recurrence is high if shoulder dislocations occur under the age of 20, which are frequently observed in men in their 20s with an active physical life. The risk decreases with advanced age.

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In case of shoulder dislocation, the patient has difficulty moving their arm upwards and feels pain. Deformity, especially occurring in the shoulder area, is one of the most obvious symptoms of shoulder dislocation.

If shoulder dislocation is suspected, the patient’s joint should not be moved and fixed with a sling. In order to relieve the pain, it is necessary to go to the health center as soon as possible by applying cold press.

For people experiencing dislocation for the first time, a closed joint is placed in its place and three weeks of rest with an arm sling is recommended. The presence of a fracture and nerve injury with shoulder dislocation should also be assessed. It is very difficult to understand the nerve injury at first, which is very painful. It requires a very careful and detailed physical examination.  In cases of shoulder dislocations due to trauma or recurrence, the capsule that holds the shoulder joint in place can also be torn and the shoulder end can stick out of the joint from this torn area. In this case named as Bankart lesion , the tears are repaired by arthroscopic surgery. Anchors with ropes are used to ensure that the tears are re-attached to the bone. In cases caused by ligament laxity, the capsule inside the joint is made tighter and stronger with shrinkage stitches.

The patient’s arm is kept fixed in a sling for about 4 weeks after the surgical procedure . Then, approximately one month of physical therapy is applied.

Factors that may cause recurrence of shoulder dislocation after Bankart Lesion surgery;

  • The patient to be less than 20 years old
  • Engaging in competitive sports
  • Engaging in contact and overhead compulsion sports
  • Ligament laxity in the shoulder joint
  • Collapse fracture in the shoulder end bone visible on the X-ray
  • Bone loss in the part of the shoulder blade across the shoulder

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