Materiały źródłowe

• #1 Dislocated shoulder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dislocated-shoulder/symptoms-causes/syc-20371715

  A dislocated shoulder is an injury in which the upper arm bone pops out of the cup-shaped socket that’s part of the shoulder blade. The shoulder is the body’s most flexible joint, which makes it more likely to dislocate. […] The shoulder joint is the most frequently dislocated joint of the body. Because it moves in several directions, your shoulder can dislocate forward, backward or downward. The most common variety is a forward (anterior) dislocation. […] Most dislocations occur through the front of the shoulder. The ligaments tissue that joins the bones of the shoulder can be stretched or torn, often making the dislocation worse. […] It takes a strong force, such as a sudden blow to the shoulder, to pull the bones out of place. Extreme twisting of the shoulder joint can pop the ball of the upper arm bone out of the shoulder socket. In a partial dislocation, the upper arm bone is partially in and partially out of the shoulder socket.

• #2 Shoulder dislocation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/shoulder-dislocation?lang=us

  The shoulder dislocation (more accurately termed a glenohumeral joint dislocation) involves separation of the humerus from the glenoid of the scapula at the glenohumeral joint. […] The shoulder is exceptionally maneuverable and sacrifices stability to enable an increase in function. Its shallow glenoid fossa, relatively weak glenohumeral ligaments, and redundant capsule render it particularly susceptible to dislocation. It is the most commonly dislocated large joint; indeed, the most commonly dislocated joint in the body. Approximately half of the major joint dislocations seen in emergency departments are of the shoulder. […] Shoulder dislocation almost exclusively occurs following trauma. The shoulder is in its weakest position when it is abducted and externally rotated. Sporting injuries and motor vehicle collisions are common causes. […] The process of dislocation is massively disruptive to the labrum, joint capsule, supporting ligaments, and muscles. This is particularly true of anterior dislocations where there can be an injury to the anterior capsule, anterior labrum, or biceps tendon, or a combination thereof.

• #3 Posterior Shoulder Dislocations – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441919/

  Posterior shoulder dislocations are relatively rare, accounting for about 2% to 5% of all shoulder dislocations. They occur when the head of the humerus is displaced backward, usually due to forceful adduction combined with internal rotation or from a blunt blow to the anterior shoulder. […] The classic mechanisms of posterior dislocation involve tonic-clonic seizures, electrical shock, or anterior-directed shoulder trauma (such as grabbing the dashboard in a motor vehicle collision or falling on an outstretched hand). These injuries create forceful internal rotation, adduction, and shoulder flexion. […] Posterior dislocations can be subclassified into 3 anatomic types based on the final resting position of the humeral head: (1) subacromial, the most common, (2) subglenoid, and (3) subspinous. Posterior dislocations usually result in the humeral head being posterior to the glenoid and inferior to the acromion. […] The most common mechanism is forceful adduction with internal rotation, but a direct, blunt blow to the anterior shoulder may also result in dislocation. Any unexplained nocturnal posterior dislocation should prompt one to consider a seizure.

• #4 Dislocated Shoulder – South Carolina Sports Medicine and Orthopaedic Center – Charleston, SC

  https://scsportsmedicine.com/sports-medicine-charleston-sc/shoulder-surgery-charleston-sc/dislocated-shoulder

  At our specialized facility in Charleston, SC, our physicians are trained to treat problems on a case by case basis. […] The shoulder is actually several joints, the main joint, the glenohumeral joint (which is most frequently dislocated) has the greatest range of motion of all joints in the body. […] There are several loose ligaments that form the shoulder capsule. These ligaments are attached to both the humeral head and glenoid. Each ligament tightens in different arm positions, thus keeping the humeral head attached to the glenoid. These ligaments are responsible for static stability. Rotator cuff muscles that originate on the scapula (wing bone) form a cuff of tendons that surround the humeral head. These rotator cuff muscles and tendons provide for dynamic stability of the glenohumeral joint.

• #5 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Shoulder dislocations are more appropriately referred to as glenohumeral dislocations. Glenohumeral dislocations are part of a broad spectrum of shoulder disorders related to instability of this joint. There is no true shoulder joint, but the ball and socket joint called the glenohumeral joint is thought of as the true shoulder joint by most people. The glenoid or socket is very shallow. The anatomic relationship is like a golf ball sitting on a tee. The ball represented by the head of the humerus, and the tee represented by the glenoid of the shoulder blade. The problem is that the tee is placed on its side and angled forward. The glenoid surface is surrounded by a lip of fibrocartilage known as the labrum. This deepens the socket for the humerus and augments stability of this joint. There is significant individual variation in the amount of ligament laxity and consequent movement at this joint. People with generalized ligament laxity, especially young women, tend to have a great deal of potential movement of the ball in the socket. The ball can move freely in most directions, especially forward and inferiorly. Because of muscle imbalance, the ball frequently sits towards the front of the socket, and this is often associated with irritation of the biceps tendon and the infraspinatus muscle of the rotator cuff, located on the back of the shoulder blade.

• #6 Dislocated Shoulder: Causes and Treatment | The Hand Society

  https://www.assh.org/handcare/condition/dislocated-shoulder

  The shoulder is unique because the stability does not come from the shape of the bones, like the hip joint, for example. Most of the stability of the shoulder comes from the soft tissues that surround the ball and socket. […] When an injury happens, these ligaments and the labrum can be damaged, and a shoulder dislocation can result. […] If a large enough force in the right direction is applied to the arm, the ball will dislocate from the socket, resulting in a dislocated shoulder. […] The decision to have surgery often comes down to the risk for re-dislocation and any other associated injuries. Repeated shoulder dislocations can lead to cartilage damage and bone loss, which in turn can lead to pain, weakness, chronic instability and osteoarthritis. […] The main goal of stabilization surgery after suffering a dislocated shoulder is to keep the shoulder in place while keeping as much range of motion as possible. This is usually done by repairing the structures that were damaged during the dislocation. […] One commonly used name for this injury is a Bankart tear. This is named after Dr. Arthur Bankart, the physician that first described it in 1923.

• #7 Dislocated Shoulder – South Carolina Sports Medicine and Orthopaedic Center – Charleston, SC

  https://scsportsmedicine.com/sports-medicine-charleston-sc/shoulder-surgery-charleston-sc/dislocated-shoulder

  At our specialized facility in Charleston, SC, our physicians are trained to treat problems on a case by case basis. […] The shoulder is actually several joints, the main joint, the glenohumeral joint (which is most frequently dislocated) has the greatest range of motion of all joints in the body. […] There are several loose ligaments that form the shoulder capsule. These ligaments are attached to both the humeral head and glenoid. Each ligament tightens in different arm positions, thus keeping the humeral head attached to the glenoid. These ligaments are responsible for static stability. Rotator cuff muscles that originate on the scapula (wing bone) form a cuff of tendons that surround the humeral head. These rotator cuff muscles and tendons provide for dynamic stability of the glenohumeral joint.

• #8 Shoulder Dislocation: Practice Essentials, Epidemiology, Functional Anatomy

  https://emedicine.medscape.com/article/93323-overview

  Shoulder dislocations may occur from a traumatic injury or from loose capsular ligaments. Different conditions may affect the stabilizing structures of the shoulder and, thus, negatively affect patients with shoulder dislocations. […] The main stabilizers of the shoulder joint are the ligaments and the capsule complex. Multiple ligaments are present, but the inferior glenohumeral ligament is the most important and the one most commonly injured during an anterior shoulder dislocation. The injury may be a tear of the ligament/capsule off one of its bony attachments, and/or it may cause a stretch injury to these structures. […] Approximately 95% of shoulder dislocations result from a major traumatic event, and 5% result from atraumatic causes. Distinguishing the type and severity of the event is important to determine the true etiology of the dislocation. This distinction is necessary to determine the treatment.

• #9 Dislocated shoulder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dislocated-shoulder/symptoms-causes/syc-20371715

  A dislocated shoulder is an injury in which the upper arm bone pops out of the cup-shaped socket that’s part of the shoulder blade. The shoulder is the body’s most flexible joint, which makes it more likely to dislocate. […] The shoulder joint is the most frequently dislocated joint of the body. Because it moves in several directions, your shoulder can dislocate forward, backward or downward. The most common variety is a forward (anterior) dislocation. […] Most dislocations occur through the front of the shoulder. The ligaments tissue that joins the bones of the shoulder can be stretched or torn, often making the dislocation worse. […] It takes a strong force, such as a sudden blow to the shoulder, to pull the bones out of place. Extreme twisting of the shoulder joint can pop the ball of the upper arm bone out of the shoulder socket. In a partial dislocation, the upper arm bone is partially in and partially out of the shoulder socket.

• #10 Reduction of Shoulder Dislocation: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/109130-overview

  Shoulder dislocation is the most common large-joint dislocation seen in the emergency department (ED). The muscular, ligamentous, and bony anatomy of the shoulder (glenohumeral joint) gives it the most extensive range of motion (ROM) of any joint in the human body. However, this anatomy also makes the glenohumeral joint the most unstable joint in the body. […] Anterior dislocations (in which the humeral head is displaced anteriorly in relation to the glenoid), account for as many as 95-98% of shoulder dislocations. The reason is that the muscular and ligamentous support anterior to the humeral head is much less robust than the substantial muscular and bony support afforded posteriorly by the rotator cuff and scapula. Anterior shoulder dislocations may be divided into the following four types: Subcoracoid (most common), Subglenoid, Subclavicular (rare), Intrathoracic (rare).

• #11 Posterior Shoulder Dislocations – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441919/

  Posterior shoulder dislocations are relatively rare, accounting for about 2% to 5% of all shoulder dislocations. They occur when the head of the humerus is displaced backward, usually due to forceful adduction combined with internal rotation or from a blunt blow to the anterior shoulder. […] The classic mechanisms of posterior dislocation involve tonic-clonic seizures, electrical shock, or anterior-directed shoulder trauma (such as grabbing the dashboard in a motor vehicle collision or falling on an outstretched hand). These injuries create forceful internal rotation, adduction, and shoulder flexion. […] Posterior dislocations can be subclassified into 3 anatomic types based on the final resting position of the humeral head: (1) subacromial, the most common, (2) subglenoid, and (3) subspinous. Posterior dislocations usually result in the humeral head being posterior to the glenoid and inferior to the acromion. […] The most common mechanism is forceful adduction with internal rotation, but a direct, blunt blow to the anterior shoulder may also result in dislocation. Any unexplained nocturnal posterior dislocation should prompt one to consider a seizure.

• #12 Posterior Shoulder Dislocations – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441919/

  Posterior shoulder dislocations are relatively rare, accounting for about 2% to 5% of all shoulder dislocations. They occur when the head of the humerus is displaced backward, usually due to forceful adduction combined with internal rotation or from a blunt blow to the anterior shoulder. […] The classic mechanisms of posterior dislocation involve tonic-clonic seizures, electrical shock, or anterior-directed shoulder trauma (such as grabbing the dashboard in a motor vehicle collision or falling on an outstretched hand). These injuries create forceful internal rotation, adduction, and shoulder flexion. […] Posterior dislocations can be subclassified into 3 anatomic types based on the final resting position of the humeral head: (1) subacromial, the most common, (2) subglenoid, and (3) subspinous. Posterior dislocations usually result in the humeral head being posterior to the glenoid and inferior to the acromion. […] The most common mechanism is forceful adduction with internal rotation, but a direct, blunt blow to the anterior shoulder may also result in dislocation. Any unexplained nocturnal posterior dislocation should prompt one to consider a seizure.

• #13 Dislocated shoulder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dislocated-shoulder/symptoms-causes/syc-20371715

  A dislocated shoulder is an injury in which the upper arm bone pops out of the cup-shaped socket that’s part of the shoulder blade. The shoulder is the body’s most flexible joint, which makes it more likely to dislocate. […] The shoulder joint is the most frequently dislocated joint of the body. Because it moves in several directions, your shoulder can dislocate forward, backward or downward. The most common variety is a forward (anterior) dislocation. […] Most dislocations occur through the front of the shoulder. The ligaments tissue that joins the bones of the shoulder can be stretched or torn, often making the dislocation worse. […] It takes a strong force, such as a sudden blow to the shoulder, to pull the bones out of place. Extreme twisting of the shoulder joint can pop the ball of the upper arm bone out of the shoulder socket. In a partial dislocation, the upper arm bone is partially in and partially out of the shoulder socket.

• #14 The Shoulder Joint – Structure – Movement – TeachMeAnatomy

  https://teachmeanatomy.info/upper-limb/joints/shoulder/

  Clinically, dislocations at the shoulder are described by where the humeral head lies in relation to the glenoid fossa. Anterior dislocations are the most prevalent (95%), although posterior (4%) and inferior (1%) dislocations can sometimes occur. Superior displacement of the humeral head is generally prevented by the coraco-acromial arch. […] Anterior dislocation is usually caused by excessive extension and lateral rotation of the humerus. The humeral head is forced anteriorly and inferiorly into the weakest part of the joint capsule. Tearing of the joint capsule is associated with an increased risk of future dislocations. Hill-Sachs lesions (impaction fracture of posterolateral humeral head against anteroinferior glenoid) and Bankart lesions (detachment of antero-inferior labrum with or without an avulsion fracture) can also occur following anterior dislocation. […] The axillary nerve runs in close proximity to the shoulder joint and around the surgical neck of the humerus, and so it can be damaged in the dislocation or with attempted reduction. Injury to the axillary nerve causes paralysis of the deltoid, and loss of sensation over regimental badge area.

• #15 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  Anterior shoulder dislocation can occur in connection with a traumatic event or as a result of an anatomical predisposition. A traumatic dislocation can damage stabilising structures, which can predispose an individual to recurrent dislocations. […] The shoulder joint is the body’s most mobile joint and is therefore particularly prone to instability. Anterior shoulder instability is most common (in approximately 95 % of cases), followed by posterior and multidirectional instability. […] According to a recent meta-analysis, as many as seven out of ten people may experience multiple instability episodes after dislocating their shoulder. The risk of recurrent dislocations depends on several factors, including the mechanism of injury, the extent of damage to the bony and soft tissue structures, and patient-specific factors such as gender, age and activity level.

• #16 Shoulder dislocation | PPT

  https://www.slideshare.net/slideshow/shoulder-dislocation-250126695/250126695

  Shoulder joint also known as Glenohumeral joint, is a ball and socket type of joint. It is inherently unstable because the Ball is big and the socket is small. Only about one-third of the humeral head is in contact with the glenoid cavity at any one time. Gleno-humoral joint stability depends on both passive and active mechanisms. Passive mechanisms include joint conformity, vacuum effect of limited joint volume, adhesion and cohesion owing to the presence of synovial fluid, scapular inclination, glenoid labrum, bony restraints, and ligamentous and capsular restraints. […] Pathological changes of shoulder dislocations include Bankarts lesion, Hill-sachs lesion, and rotator cuff tear. Anterior dislocation may occur as a result of trauma, with indirect trauma to the upper extremity with the shoulder in abduction, extension, and external rotation being the most common mechanism. Direct trauma involves an anteriorly directed impact to the posterior shoulder.

• #17 THE ANTERIOR CAPSULAR MECHANISM IN RECURRENT ANTERIOR DISLOCATION OF THE SHOULDER | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/0301-620X.44B4.913

  4. The present work shows, from a basic standpoint, that Bankart’s original idea that the recurrent state was due to the failure of healing of the fractured fibrocartilaginous glenoid labrum is no longer tenable. […] 5. Finally, the anomalous attachment or the insufficient development of the middle gleno-humeral ligament in certain cases of recurrent anterior shoulder dislocation is shown to provide the anatomical basis for the recurrent state in these cases; this is the weak area in the antero-inferior part of the capsule which has been described in the literature for the past hundred years. Thus we have returned to the original view of Hippocrates.

• #18 Gaballah, Zeyada, Elgeidi, and Bressel: Six-week physical rehabilitation protocol for anterior shoulder dislocation in athletes

  https://www.e-jer.org/journal/view.php?number=2013600392

  Anterior shoulder dislocations are common in young athletes. The mechanism for the first or primary shoulder dislocation may involve a collision or a fall typically with the arm in an abducted and externally rotated position. […] The mechanism of the first dislocations occurs after a forceful direct trauma or a fall typically with the arm in an abducted and externally rotated or outstretched arm. […] The disparity between the large humeral head and the small glenoid cavity increasing the joint ability to be injured. […] The anteriorly dislocated humeral head causes a labrum tear of the anterior and inferior labrum, a Bankart injury, and a typical impression fracture. […] The goal of the primary rehabilitation for the acute anterior shoulder is to prevent long-term instability for the shoulder joint.

• #19 Shoulder Dislocation – Treatment, Management, Exercise – Brisbane Physiotherapy & Podiatry

  https://www.brisbanephysiotherapy.com/news/dislocated-shoulder

  A shoulder dislocation occurs when the ball of your humerus (upper arm bone) is pulled out of its normal position in the shoulder socket (glenoid labrum). […] Mechanism of injury: excessive abduction and external rotation. […] Mechanism of injury: Acute trauma, either direct or indirect, associated with sudden onset of acute shoulder pain, when the shoulder is in a non-optimal and vulnerable position and is displaced out of its joint socket. […] Because of this high incidence of recurrent dislocation, an arthroscopy should be considered after shoulder dislocation as it reduces risk of recurrent instability.

• #20 Dislocated shoulder – Wikipedia

  https://en.wikipedia.org/wiki/Dislocated_shoulder

  A dislocated shoulder is a condition in which the head of the humerus is detached from the glenoid fossa. Symptoms include shoulder pain and instability. Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve. […] A shoulder dislocation often occurs as a result of a fall onto an outstretched arm or onto the shoulder. Diagnosis is typically based on symptoms and confirmed by X-rays. They are classified as anterior, posterior, inferior, and superior with most being anterior. […] Anterior dislocations are usually caused by a direct blow to, or fall on, an outstretched arm. The person typically holds his/her arm externally rotated and slightly abducted. […] A Hill-Sachs lesion is an impaction of the head of the humerus left by the glenoid rim during dislocation. Hill-Sachs deformities occur in 35-40% of anterior dislocations. They can be seen on a front-facing X-ray when the arm is in internal rotation. Bankart lesions are disruptions of the glenoid labrum with or without an avulsion of bone fragment.

• #21 Shoulder Dislocation Pathology

  https://flawlessmotion.com/pages/shoulder-dislocation-pathology?srsltid=AfmBOoozWiKCITT8rl-mjql94eXnelD1O7nIgCUdlVU1T5LGeFJ59nSh

  Any movement of the humeral head out of the socket can result in damage to your shoulder joint. Younger people tend to damage the labrum, while people over the age of 40 years tend to tear a rotator cuff muscle. […] When a shoulder dislocates or subluxes the cartilage (labrum) that deepens the socket can be torn. This typically happens in the front and bottom of the socket. The tear that occurs in the labrum is called a Bankart lesion. […] Sometimes the bone can also be damaged. It is known as a bony Bankart lesion. […] A Hill Sachs lesion can occur when your humerus comes out of its socket. The bone is the humeral head is softer than the bone of the glenoid socket. This causes an indentation in the bone in the humeral head. […] Hill Sachs lesions are definitive proof that your shoulder has come out of its socket. […] A HAGL lesion is when the shoulder capsule is torn from the end that attaches to the humerus. This lesion occurs at the opposite end of the capsule than a Bankart lesion.

• #22 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  The joint capsule and labrum will almost always be damaged in cases of first-time shoulder dislocation. The labrum plays a key role in glenohumeral stability and has to remain intact in order to maintain the negative intraarticular pressure (the vacuum effect) that keeps the humeral head in contact with the glenoid labrum. […] A damaged labrum reduces the height of the glenoid rim by 80 %. Other structures that are often injured during anterior shoulder dislocation are the rotator cuff, the glenohumeral ligaments, the long head of the biceps tendon and its attachment to the glenoid labrum, and articular cartilage. […] A bony injury in connection with anterior shoulder dislocation increases the risk of recurrent instability episodes and a reduced function level. The glenoid fragment is usually resorbed, and this reduces the joint surface. Glenoid bone loss of 15-20 % is considered to be a critical limit, because it increases the risk of repeated instability episodes and impaired shoulder function.

• #23 Dislocated shoulder – Wikipedia

  https://en.wikipedia.org/wiki/Dislocated_shoulder

  Damage to the axillary artery and axillary nerve (C5, C6) may result. The axillary nerve is injured in 37% making it the most commonly injured structure with this type of injury. Other common, associated, nerve injuries include injury to the suprascapular nerve (29%) and the radial nerve (22%). […] Inferior dislocation is the least likely, occurring in less than 1%. This condition is also called luxatio erecta because the arm appears to be permanently held upward or behind the head. It is caused by a hyper abduction of the arm that forces the humeral head against the acromion. Such injuries have a high complication rate as many vascular, neurological, tendon, and ligament injuries are likely to occur from this mechanism of injury. […] Shoulder reduction may be accomplished with a number of techniques including traction-countertraction, external rotation, scapular manipulation, Stimson technique, Cunningham technique, or Milch technique. Pain can be managed during the procedures either by procedural sedation and analgesia or injected lidocaine into the shoulder joint.

• #24 Dislocated shoulder: Causes, types, symptoms, diagnosis | Kenhub

  https://www.kenhub.com/en/library/anatomy/clinical-case-dislocated-shoulder

  Damage to the axillary nerve (C5, C6) occurs in about 1/3 of anterior shoulder dislocations. […] Rupture of these small arteries is rarely associated with simple anterior dislocation. Fracture of the greater tubercle increases the likelihood of avascular necrosis. […] The rotator cuff is a group of four muscles that act primarily to rotate and stabilize the humerus.

• #25 Reduction of Shoulder Dislocation: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/109130-overview

  Posterior shoulder dislocations are considerably less common, accounting for fewer than 4% of shoulder dislocations. Many posterior shoulder dislocations are initially missed by treating physicians, and diagnosis is delayed in many cases. Failure to diagnose and treat posterior dislocations promptly can result in complications, including recurrent dislocations, avascular necrosis of the humeral head, degenerative disease, and chronic pain. […] Inferior glenohumeral dislocation (luxatio erecta humeri) is rare, accounting for fewer than 1% of all shoulder dislocations. Most cases arise from forceful hyperabduction of the shoulder. This initially results in impingement of the humeral head against the acromion, and the leverage caused by this impingement ultimately drives the humeral head downward, causing it to disrupt the inferior portion of the glenohumeral capsule and dislocate. Forceful, direct axial loading of an abducted shoulder can also result in luxatio erecta. […] Most shoulder dislocations are straightforward and can easily be reduced in the ED by using one of several techniques. However, recalcitrant cases do occur, and clinicians need to be alert for coincident injuries and complications.

• #26 Posterior Shoulder Dislocations – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441919/

  Posterior shoulder dislocations are relatively rare, accounting for about 2% to 5% of all shoulder dislocations. They occur when the head of the humerus is displaced backward, usually due to forceful adduction combined with internal rotation or from a blunt blow to the anterior shoulder. […] The classic mechanisms of posterior dislocation involve tonic-clonic seizures, electrical shock, or anterior-directed shoulder trauma (such as grabbing the dashboard in a motor vehicle collision or falling on an outstretched hand). These injuries create forceful internal rotation, adduction, and shoulder flexion. […] Posterior dislocations can be subclassified into 3 anatomic types based on the final resting position of the humeral head: (1) subacromial, the most common, (2) subglenoid, and (3) subspinous. Posterior dislocations usually result in the humeral head being posterior to the glenoid and inferior to the acromion. […] The most common mechanism is forceful adduction with internal rotation, but a direct, blunt blow to the anterior shoulder may also result in dislocation. Any unexplained nocturnal posterior dislocation should prompt one to consider a seizure.

• #27 Posterior Shoulder Dislocation • LITFL • Trauma Library

  https://litfl.com/posterior-shoulder-dislocation/

  Posterior shoulder dislocations make up a small minority of total shoulder dislocation cases, accounting for 2-4% of presentations. However because of a low level of clinical suspicion and insufficient imaging, they are often missed. […] Approximately half of posterior shoulder dislocations go undiagnosed on initial presentation. […] Traditionally posterior dislocations have been associated with epileptic seizures, high energy trauma, electrocution and electroconvulsive therapy (ECT), although the incidence associated with ECT especially has decreased somewhat in recent years. […] In traumatic posterior dislocations, the injury is almost always due to a fall onto an outstretched, internally rotated arm. The force of the impact pushes the head of the humerus posteriorly out of the glenoid cavity.

• #28 Posterior Shoulder Dislocation • LITFL • Trauma Library

  https://litfl.com/posterior-shoulder-dislocation/

  An impaction fracture of the anteromedial aspect of the humeral head (McLaughin lesion or reverse Hill-Sachs lesion) may result from the humerus being forced against the posterior lip of the glenoid. […] If enlocation is delayed, it can worsen the severity of this lesion and lead to further complications. Dislocation may also result in capsulolabral tears, glenoid rim fractures or rotator cuff tears. […] When a bilateral posterior dislocation is present, it is almost always secondary to seizure activity. With seizure activity, the internal rotator muscles (teres major and subscapularis) overpower the external rotator muscles (teres minor, infraspinatus) to dislocate the head of humerus. […] A posterior dislocation should be considered as a differential in any episode of shoulder pain and immobility after a seizure.

• #29

  https://www.orthobullets.com/shoulder-and-elbow/3051/posterior-shoulder-instability-and-dislocation

  May lead to gradual stretching of capsule and patulous posterior capsule, common in lineman, weight lifters, overhead athletes. […] Seizures and electric shock: tetanic muscle contraction pulls the humeral head out. […] Anterior instability and dislocations are still more common with seizures; however, posterior dislocations are unlikely to occur without significant trauma (ie. seizures). […] Biomechanical forces: flexed, adducted, and internally rotated arm is a high-risk position.

• #30 Posterior Shoulder Dislocation • LITFL • Trauma Library

  https://litfl.com/posterior-shoulder-dislocation/

  Posterior shoulder dislocations make up a small minority of total shoulder dislocation cases, accounting for 2-4% of presentations. However because of a low level of clinical suspicion and insufficient imaging, they are often missed. […] Approximately half of posterior shoulder dislocations go undiagnosed on initial presentation. […] Traditionally posterior dislocations have been associated with epileptic seizures, high energy trauma, electrocution and electroconvulsive therapy (ECT), although the incidence associated with ECT especially has decreased somewhat in recent years. […] In traumatic posterior dislocations, the injury is almost always due to a fall onto an outstretched, internally rotated arm. The force of the impact pushes the head of the humerus posteriorly out of the glenoid cavity.

• #31 Posterior shoulder dislocation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/posterior-shoulder-dislocation?lang=us

  Posterior shoulder dislocations are far less common than anterior shoulder dislocations and can be difficult to identify if only AP projections are obtained. A high index of suspicion is helpful. […] Typically the humeral head is forced posteriorly in internal rotation while the arm is abducted. In adults, convulsive disorders are the most common cause. Electrocution is a classic but uncommon cause of posterior shoulder dislocation. In both situations, bilateral dislocations are not infrequent. […] Occasionally, they can be the result of strength imbalance within the rotator cuff muscles. Posterior dislocations may even go unnoticed, especially in elderly patients.

• #32 Posterior Shoulder Dislocation • LITFL • Trauma Library

  https://litfl.com/posterior-shoulder-dislocation/

  An impaction fracture of the anteromedial aspect of the humeral head (McLaughin lesion or reverse Hill-Sachs lesion) may result from the humerus being forced against the posterior lip of the glenoid. […] If enlocation is delayed, it can worsen the severity of this lesion and lead to further complications. Dislocation may also result in capsulolabral tears, glenoid rim fractures or rotator cuff tears. […] When a bilateral posterior dislocation is present, it is almost always secondary to seizure activity. With seizure activity, the internal rotator muscles (teres major and subscapularis) overpower the external rotator muscles (teres minor, infraspinatus) to dislocate the head of humerus. […] A posterior dislocation should be considered as a differential in any episode of shoulder pain and immobility after a seizure.

• #33 Posterior Shoulder Dislocations | Orthopedic Center for Sports Medicine

  https://nolasportsmedicine.com/posterior-shoulder-dislocations/

  The anatomic configuration of the shoulder joint known as the glenohumeral joint is often compared to a golf ball on a tee. It is the most mobile joint in the body allowing the arm to move in many directions which is why it is the most frequently dislocated joint in the human body. The stability and movement at the shoulder is controlled by the rotator cuff muscles, ligaments, and the capsulolabral complex of the shoulder. There are three main types of dislocations depending on displacement direction of the humeral head: anterior, inferior and posterior. Posterior dislocations also known as Reverse Hill-Sachs lesion are those in which the humeral head has moved backward toward the shoulder blade and they attribute to 4% of all shoulder dislocations. […] Dislocations of the shoulder occur when the head of the humerus is forcibly removed from its socket in the glenoid fossa. The most common cause for posterior dislocations is anterior trauma to the shoulder such as blunt force. Seizures (epileptic, hypoglycemic, drug-induced, etc.) or electric shocks such as being hit by lightning or being electrocuted can also cause unilateral or bilateral posterior dislocations due to unbalanced muscle contractions pulling the humeral head backwards. Sport activities that may lead to posterior shoulder instability include heavy bench pressing and football linemen blocking. Other sports where this type of dislocation is commonly seen are basketball and volleyball.

• #34 Reduction of Shoulder Dislocation: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/109130-overview

  Posterior shoulder dislocations are considerably less common, accounting for fewer than 4% of shoulder dislocations. Many posterior shoulder dislocations are initially missed by treating physicians, and diagnosis is delayed in many cases. Failure to diagnose and treat posterior dislocations promptly can result in complications, including recurrent dislocations, avascular necrosis of the humeral head, degenerative disease, and chronic pain. […] Inferior glenohumeral dislocation (luxatio erecta humeri) is rare, accounting for fewer than 1% of all shoulder dislocations. Most cases arise from forceful hyperabduction of the shoulder. This initially results in impingement of the humeral head against the acromion, and the leverage caused by this impingement ultimately drives the humeral head downward, causing it to disrupt the inferior portion of the glenohumeral capsule and dislocate. Forceful, direct axial loading of an abducted shoulder can also result in luxatio erecta. […] Most shoulder dislocations are straightforward and can easily be reduced in the ED by using one of several techniques. However, recalcitrant cases do occur, and clinicians need to be alert for coincident injuries and complications.

• #35 Posterior Shoulder Dislocations | Orthopedic Center for Sports Medicine

  https://nolasportsmedicine.com/posterior-shoulder-dislocations/

  Treatment strategy varies from conservative treatments to operative options. […] Closed reduction is the initial treatment for all acute posterior dislocations and immobilization with a sling is important to decrease the risk of a repeat dislocation. Medications may be required for sedation to help relax the muscles surrounding the shoulder and facilitate the reduction. In order to reduce the humeral head into the glenoid fossa, forward pressure on the humeral head must be applied with the arm in the flexed, adducted (close to the body) and internally rotated position (across the body). After the closed reduction, the arm must be kept in a gunslinger splint with 10 of abduction (away from the body) and neutral rotation for approximately six weeks. Once the shoulder has been reduced a post reduction X-ray is recommended to reexamine the arm and make certain that no damage occurred during the reduction procedure. Activities that require to place the arm in high-risk positions such as hyper internal rotation (across the body) are prohibited until 12 weeks.

• #36 Reduction of Shoulder Dislocation: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/109130-overview

  Posterior shoulder dislocations are considerably less common, accounting for fewer than 4% of shoulder dislocations. Many posterior shoulder dislocations are initially missed by treating physicians, and diagnosis is delayed in many cases. Failure to diagnose and treat posterior dislocations promptly can result in complications, including recurrent dislocations, avascular necrosis of the humeral head, degenerative disease, and chronic pain. […] Inferior glenohumeral dislocation (luxatio erecta humeri) is rare, accounting for fewer than 1% of all shoulder dislocations. Most cases arise from forceful hyperabduction of the shoulder. This initially results in impingement of the humeral head against the acromion, and the leverage caused by this impingement ultimately drives the humeral head downward, causing it to disrupt the inferior portion of the glenohumeral capsule and dislocate. Forceful, direct axial loading of an abducted shoulder can also result in luxatio erecta. […] Most shoulder dislocations are straightforward and can easily be reduced in the ED by using one of several techniques. However, recalcitrant cases do occur, and clinicians need to be alert for coincident injuries and complications.

• #37

  https://www.orthobullets.com/shoulder-and-elbow/3132/luxatio-erecta-inferior-glenohumeral-joint-dislocation

  Luxatio Erecta is the specific term for inferior dislocation of the glenohumeral joint trapped underneath the coracoid and glenoid, very commonly associated with neurovascular injury. […] Pathophysiology typically involves a high-energy injury, with a hyperabduction force applied to the arm, levering the proximal humerus onto the acromion, injuring the inferior capsule/labrum, which subsequently allows for disengagement of the humeral head inferiorly from the glenoid. […] This condition commonly involves variable sized tearing of static glenohumeral ligaments.

• #38

  https://www.orthobullets.com/shoulder-and-elbow/3132/luxatio-erecta-inferior-glenohumeral-joint-dislocation

  Luxatio Erecta is the specific term for inferior dislocation of the glenohumeral joint trapped underneath the coracoid and glenoid, very commonly associated with neurovascular injury. […] Pathophysiology typically involves a high-energy injury, with a hyperabduction force applied to the arm, levering the proximal humerus onto the acromion, injuring the inferior capsule/labrum, which subsequently allows for disengagement of the humeral head inferiorly from the glenoid. […] This condition commonly involves variable sized tearing of static glenohumeral ligaments.

• #39 Dislocated shoulder – Wikipedia

  https://en.wikipedia.org/wiki/Dislocated_shoulder

  Damage to the axillary artery and axillary nerve (C5, C6) may result. The axillary nerve is injured in 37% making it the most commonly injured structure with this type of injury. Other common, associated, nerve injuries include injury to the suprascapular nerve (29%) and the radial nerve (22%). […] Inferior dislocation is the least likely, occurring in less than 1%. This condition is also called luxatio erecta because the arm appears to be permanently held upward or behind the head. It is caused by a hyper abduction of the arm that forces the humeral head against the acromion. Such injuries have a high complication rate as many vascular, neurological, tendon, and ligament injuries are likely to occur from this mechanism of injury. […] Shoulder reduction may be accomplished with a number of techniques including traction-countertraction, external rotation, scapular manipulation, Stimson technique, Cunningham technique, or Milch technique. Pain can be managed during the procedures either by procedural sedation and analgesia or injected lidocaine into the shoulder joint.

• #40

  https://www.orthobullets.com/shoulder-and-elbow/3132/luxatio-erecta-inferior-glenohumeral-joint-dislocation

  Luxatio Erecta is the specific term for inferior dislocation of the glenohumeral joint trapped underneath the coracoid and glenoid, very commonly associated with neurovascular injury. […] Pathophysiology typically involves a high-energy injury, with a hyperabduction force applied to the arm, levering the proximal humerus onto the acromion, injuring the inferior capsule/labrum, which subsequently allows for disengagement of the humeral head inferiorly from the glenoid. […] This condition commonly involves variable sized tearing of static glenohumeral ligaments.

• #41 Shoulder Dislocation : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/shoulder-dislocation/

  Mechanism of injury involving forceful hyperabduction of arm. […] Axillary nerve compromise may initially present in >40% of shoulder dislocations. […] There are 3 main steps to reducing/managing shoulder dislocations: […] Rule out contraindications to reduction. […] Shoulder reduction (with or without analgesia). […] Post reduction management. […] Contraindications to Immediate Reduction […] Multipart fractures. […] Fractures of surgical neck (risk of avascular necrosis). […] Open fractures (unless neurovascular deficits present). […] Delayed reductions (> 6 weeks) in posterior dislocations. […] Signs of vascular injury in inferior dislocations. […] Analgesia/sedation is recommended in delayed reductions (> 3 weeks) or posterior/inferior dislocations. […] Intra-articular anesthesia and nerve blocks are preferred over procedural sedation, when possible. […] Surgical benefit must be considered against the cost, so referral criteria remains largely provider dependent — many clinicians consider referral after 2 atraumatic anterior dislocations.

• #42 Dislocated shoulder – Wikipedia

  https://en.wikipedia.org/wiki/Dislocated_shoulder

  Damage to the axillary artery and axillary nerve (C5, C6) may result. The axillary nerve is injured in 37% making it the most commonly injured structure with this type of injury. Other common, associated, nerve injuries include injury to the suprascapular nerve (29%) and the radial nerve (22%). […] Inferior dislocation is the least likely, occurring in less than 1%. This condition is also called luxatio erecta because the arm appears to be permanently held upward or behind the head. It is caused by a hyper abduction of the arm that forces the humeral head against the acromion. Such injuries have a high complication rate as many vascular, neurological, tendon, and ligament injuries are likely to occur from this mechanism of injury. […] Shoulder reduction may be accomplished with a number of techniques including traction-countertraction, external rotation, scapular manipulation, Stimson technique, Cunningham technique, or Milch technique. Pain can be managed during the procedures either by procedural sedation and analgesia or injected lidocaine into the shoulder joint.

• #43 Shoulder dislocation – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/shoulder-dislocation/

  In shoulder dislocation, the head of the humerus dislocates completely or partially (subluxation) in one of three directions: anterior (most common), posterior, or inferior. […] Anatomy: The head of the humerus is larger than the shallow glenoid fossa, which accounts for the high incidence of shoulder dislocation. […] Possible complications of shoulder dislocation include neurovascular damage (most commonly axillary nerve injury), continued instability, restricted range of motion, and rotator cuff injury. […] Axillary nerve injury is common with inferior shoulder dislocation. […] Hill-Sachs lesion; A depression fracture on the posterolateral surface of the humeral head caused by impact with the glenoid rim. […] Highly prevalent in patients with an anterior shoulder dislocation. […] Increases the risk of glenohumeral instability and recurrent shoulder dislocation.

• #44 Shoulder Dislocation : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/shoulder-dislocation/

  Mechanism of injury involving forceful hyperabduction of arm. […] Axillary nerve compromise may initially present in >40% of shoulder dislocations. […] There are 3 main steps to reducing/managing shoulder dislocations: […] Rule out contraindications to reduction. […] Shoulder reduction (with or without analgesia). […] Post reduction management. […] Contraindications to Immediate Reduction […] Multipart fractures. […] Fractures of surgical neck (risk of avascular necrosis). […] Open fractures (unless neurovascular deficits present). […] Delayed reductions (> 6 weeks) in posterior dislocations. […] Signs of vascular injury in inferior dislocations. […] Analgesia/sedation is recommended in delayed reductions (> 3 weeks) or posterior/inferior dislocations. […] Intra-articular anesthesia and nerve blocks are preferred over procedural sedation, when possible. […] Surgical benefit must be considered against the cost, so referral criteria remains largely provider dependent — many clinicians consider referral after 2 atraumatic anterior dislocations.

• #45 Shoulder Dislocation : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/shoulder-dislocation/

  Mechanism of injury involving forceful hyperabduction of arm. […] Axillary nerve compromise may initially present in >40% of shoulder dislocations. […] There are 3 main steps to reducing/managing shoulder dislocations: […] Rule out contraindications to reduction. […] Shoulder reduction (with or without analgesia). […] Post reduction management. […] Contraindications to Immediate Reduction […] Multipart fractures. […] Fractures of surgical neck (risk of avascular necrosis). […] Open fractures (unless neurovascular deficits present). […] Delayed reductions (> 6 weeks) in posterior dislocations. […] Signs of vascular injury in inferior dislocations. […] Analgesia/sedation is recommended in delayed reductions (> 3 weeks) or posterior/inferior dislocations. […] Intra-articular anesthesia and nerve blocks are preferred over procedural sedation, when possible. […] Surgical benefit must be considered against the cost, so referral criteria remains largely provider dependent — many clinicians consider referral after 2 atraumatic anterior dislocations.

• #46 Shoulder Dislocation: Practice Essentials, Epidemiology, Functional Anatomy

  https://emedicine.medscape.com/article/93323-overview

  Age at dislocation is the most important prognostic indicator for recurrence of shoulder dislocations. Younger age at initial injury increases the likelihood for future dislocation. The recurrence rate is thought to be 90% if the initial episode occurs in the teen years. In patients aged 40 years or older, the recurrence rate is 10-15%. Most redislocations occur within 2 years of the primary injury. […] The most common complication of an acute shoulder dislocation is recurrence. This complication occurs because the capsule and surrounding ligaments are stretched and deformed during the dislocation. Age is the most important indicator for prognosis; dislocations recur in approximately 90% of teenagers.

• #47 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The geometry of glenohumeral articulation permits great flexibility at the expense of intrinsic stability. This inherent instability makes the shoulder the most commonly dislocated joint in the body, which can lead to recurrent dislocations or subluxations. In particular, young, active males under the age of 30 have an increased risk of recurrent instability. Nearly half (48.6%) of all shoulder dislocations occur in patients 15 to 29 years old, with the highest rate of recurrent dislocations (64%) found in those under age 30 and a male-to-female incidence rate ratio of 2.64. With evolving knowledge of this common injury, optimal management of primary anterior shoulder dislocations remains controversial. […] Recurrent shoulder instability following a traumatic dislocation usually develops within the first 2 years of primary dislocation. Because the first 2 years following a primary anterior shoulder dislocation are crucial in long-term outcomes, understanding the optimal management following common anterior shoulder dislocations will assist both physicians and patients in deciding between courses of treatment.

• #48 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  The joint capsule and labrum will almost always be damaged in cases of first-time shoulder dislocation. The labrum plays a key role in glenohumeral stability and has to remain intact in order to maintain the negative intraarticular pressure (the vacuum effect) that keeps the humeral head in contact with the glenoid labrum. […] A damaged labrum reduces the height of the glenoid rim by 80 %. Other structures that are often injured during anterior shoulder dislocation are the rotator cuff, the glenohumeral ligaments, the long head of the biceps tendon and its attachment to the glenoid labrum, and articular cartilage. […] A bony injury in connection with anterior shoulder dislocation increases the risk of recurrent instability episodes and a reduced function level. The glenoid fragment is usually resorbed, and this reduces the joint surface. Glenoid bone loss of 15-20 % is considered to be a critical limit, because it increases the risk of repeated instability episodes and impaired shoulder function.

• #49 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The commonality of recurrent anterior shoulder dislocations can be attributed to the shoulder anatomy deformities present following initial dislocation. Such injury-caused deformities include abnormal laxity of the joint capsule and surrounding muscles, deformities of the head of the humerus, and contracture of the muscles surrounding the glenohumeral joint. Of note, greater tuberosity fractures have been shown to decrease the risk of recurrent instability in patients who obtained the injury in first-time traumatic anterior shoulder dislocations. Subsequent anterior shoulder dislocations increase the risk of glenoid bone loss, exacerbating the already existent shoulder deformities present after initial injury. An evaluation of 714 athletes found a glenoid bone loss of 6.8% after a first-time anterior shoulder instability event and a total calculated glenoid bone loss of 22.8% in the setting of recurrent instability. A primary study evaluating recurrent dislocations in cases of glenoid bone loss found recurrence rates similar to the rest of the literature, with a 27% rate in patients over 30 and a 72% rate in patients under 23 years old. In addition, more recent studies, including a systematic review and meta-analysis, found that younger patient age, male sex, glenohumeral joint hyperlaxity, higher activity levels, increased pain, and higher levels of reinjury fear also increase the risk of dislocation recurrence.

• #50

  https://www.ijoro.org/index.php/ijoro/article/view/3492

  Shoulder dislocation, soft tissue and bony injuries around shoulder has close relation and hence, detail investigation and diagnosis plays a crucial role in prognosis and further treatment. […] Prospective observational study was done on patients with acute shoulder dislocation. After ab arthroscopic evaluation, majority 77% of patients had capsulo-labral detachments. 61% of first dislocations showed capsulo-labral detachment/Bankart lesions and all the recurrent dislocations had partial or complete capsule-labral detachment or Bankart lesions. Glenohumeral ligament integrity was disturbed in 58% of recurrent and that of 11% of first time shoulder dislocation cases. Hillsach lesions are in total of 57% of all soft tissue injuries. Bony Bankart lesions were found in 50% of recurrent dislocations. Rotator tears are mainly in recurrent dislocation cases mainly 40 years of age.

• #51 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The commonality of recurrent anterior shoulder dislocations can be attributed to the shoulder anatomy deformities present following initial dislocation. Such injury-caused deformities include abnormal laxity of the joint capsule and surrounding muscles, deformities of the head of the humerus, and contracture of the muscles surrounding the glenohumeral joint. Of note, greater tuberosity fractures have been shown to decrease the risk of recurrent instability in patients who obtained the injury in first-time traumatic anterior shoulder dislocations. Subsequent anterior shoulder dislocations increase the risk of glenoid bone loss, exacerbating the already existent shoulder deformities present after initial injury. An evaluation of 714 athletes found a glenoid bone loss of 6.8% after a first-time anterior shoulder instability event and a total calculated glenoid bone loss of 22.8% in the setting of recurrent instability. A primary study evaluating recurrent dislocations in cases of glenoid bone loss found recurrence rates similar to the rest of the literature, with a 27% rate in patients over 30 and a 72% rate in patients under 23 years old. In addition, more recent studies, including a systematic review and meta-analysis, found that younger patient age, male sex, glenohumeral joint hyperlaxity, higher activity levels, increased pain, and higher levels of reinjury fear also increase the risk of dislocation recurrence.

• #52 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  The joint capsule and labrum will almost always be damaged in cases of first-time shoulder dislocation. The labrum plays a key role in glenohumeral stability and has to remain intact in order to maintain the negative intraarticular pressure (the vacuum effect) that keeps the humeral head in contact with the glenoid labrum. […] A damaged labrum reduces the height of the glenoid rim by 80 %. Other structures that are often injured during anterior shoulder dislocation are the rotator cuff, the glenohumeral ligaments, the long head of the biceps tendon and its attachment to the glenoid labrum, and articular cartilage. […] A bony injury in connection with anterior shoulder dislocation increases the risk of recurrent instability episodes and a reduced function level. The glenoid fragment is usually resorbed, and this reduces the joint surface. Glenoid bone loss of 15-20 % is considered to be a critical limit, because it increases the risk of repeated instability episodes and impaired shoulder function.

• #53 Shoulder Dislocation: Practice Essentials, Epidemiology, Functional Anatomy

  https://emedicine.medscape.com/article/93323-overview

  Age at dislocation is the most important prognostic indicator for recurrence of shoulder dislocations. Younger age at initial injury increases the likelihood for future dislocation. The recurrence rate is thought to be 90% if the initial episode occurs in the teen years. In patients aged 40 years or older, the recurrence rate is 10-15%. Most redislocations occur within 2 years of the primary injury. […] The most common complication of an acute shoulder dislocation is recurrence. This complication occurs because the capsule and surrounding ligaments are stretched and deformed during the dislocation. Age is the most important indicator for prognosis; dislocations recur in approximately 90% of teenagers.

• #54 Shoulder Dislocation – Sports Clinic NQ

  https://sportsclinicnq.com.au/shoulder-dislocation/

  If you are under 20, your likelihood of re-dislocation is extremely high. Published studies range between 70-100%, but in athletes who are hoping to return to high level contact or throwing sports the rate is actually close to 100%. This is because young people are generally more flexible and have slightly different collagen in their ligaments. If you are under 20 you are more likely to need surgery to stabilize the shoulder so that it doesnt pop back out again you should seriously consider having early surgery after your first dislocation. […] If you are over 40, the likelihood of re-dislocation is quite low. When you are over 40 you are more likely to tear the tissue rather than stretch it and more likely to develop scar tissue. This may leave you with a stiff shoulder rather than one that will continually pop back out.

• #55 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The commonality of recurrent anterior shoulder dislocations can be attributed to the shoulder anatomy deformities present following initial dislocation. Such injury-caused deformities include abnormal laxity of the joint capsule and surrounding muscles, deformities of the head of the humerus, and contracture of the muscles surrounding the glenohumeral joint. Of note, greater tuberosity fractures have been shown to decrease the risk of recurrent instability in patients who obtained the injury in first-time traumatic anterior shoulder dislocations. Subsequent anterior shoulder dislocations increase the risk of glenoid bone loss, exacerbating the already existent shoulder deformities present after initial injury. An evaluation of 714 athletes found a glenoid bone loss of 6.8% after a first-time anterior shoulder instability event and a total calculated glenoid bone loss of 22.8% in the setting of recurrent instability. A primary study evaluating recurrent dislocations in cases of glenoid bone loss found recurrence rates similar to the rest of the literature, with a 27% rate in patients over 30 and a 72% rate in patients under 23 years old. In addition, more recent studies, including a systematic review and meta-analysis, found that younger patient age, male sex, glenohumeral joint hyperlaxity, higher activity levels, increased pain, and higher levels of reinjury fear also increase the risk of dislocation recurrence.

• #56 Shoulder Dislocation: Practice Essentials, Epidemiology, Functional Anatomy

  https://emedicine.medscape.com/article/93323-overview

  Age at dislocation is the most important prognostic indicator for recurrence of shoulder dislocations. Younger age at initial injury increases the likelihood for future dislocation. The recurrence rate is thought to be 90% if the initial episode occurs in the teen years. In patients aged 40 years or older, the recurrence rate is 10-15%. Most redislocations occur within 2 years of the primary injury. […] The most common complication of an acute shoulder dislocation is recurrence. This complication occurs because the capsule and surrounding ligaments are stretched and deformed during the dislocation. Age is the most important indicator for prognosis; dislocations recur in approximately 90% of teenagers.

• #57 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The geometry of glenohumeral articulation permits great flexibility at the expense of intrinsic stability. This inherent instability makes the shoulder the most commonly dislocated joint in the body, which can lead to recurrent dislocations or subluxations. In particular, young, active males under the age of 30 have an increased risk of recurrent instability. Nearly half (48.6%) of all shoulder dislocations occur in patients 15 to 29 years old, with the highest rate of recurrent dislocations (64%) found in those under age 30 and a male-to-female incidence rate ratio of 2.64. With evolving knowledge of this common injury, optimal management of primary anterior shoulder dislocations remains controversial. […] Recurrent shoulder instability following a traumatic dislocation usually develops within the first 2 years of primary dislocation. Because the first 2 years following a primary anterior shoulder dislocation are crucial in long-term outcomes, understanding the optimal management following common anterior shoulder dislocations will assist both physicians and patients in deciding between courses of treatment.

• #58 Shoulder Dislocation Pathology

  https://flawlessmotion.com/pages/shoulder-dislocation-pathology?srsltid=AfmBOoozWiKCITT8rl-mjql94eXnelD1O7nIgCUdlVU1T5LGeFJ59nSh

  Any movement of the humeral head out of the socket can result in damage to your shoulder joint. Younger people tend to damage the labrum, while people over the age of 40 years tend to tear a rotator cuff muscle. […] When a shoulder dislocates or subluxes the cartilage (labrum) that deepens the socket can be torn. This typically happens in the front and bottom of the socket. The tear that occurs in the labrum is called a Bankart lesion. […] Sometimes the bone can also be damaged. It is known as a bony Bankart lesion. […] A Hill Sachs lesion can occur when your humerus comes out of its socket. The bone is the humeral head is softer than the bone of the glenoid socket. This causes an indentation in the bone in the humeral head. […] Hill Sachs lesions are definitive proof that your shoulder has come out of its socket. […] A HAGL lesion is when the shoulder capsule is torn from the end that attaches to the humerus. This lesion occurs at the opposite end of the capsule than a Bankart lesion.

• #59 Shoulder Dislocation – Sports Clinic NQ

  https://sportsclinicnq.com.au/shoulder-dislocation/

  If you are under 20, your likelihood of re-dislocation is extremely high. Published studies range between 70-100%, but in athletes who are hoping to return to high level contact or throwing sports the rate is actually close to 100%. This is because young people are generally more flexible and have slightly different collagen in their ligaments. If you are under 20 you are more likely to need surgery to stabilize the shoulder so that it doesnt pop back out again you should seriously consider having early surgery after your first dislocation. […] If you are over 40, the likelihood of re-dislocation is quite low. When you are over 40 you are more likely to tear the tissue rather than stretch it and more likely to develop scar tissue. This may leave you with a stiff shoulder rather than one that will continually pop back out.

• #60 Dislocated Shoulder | Shoulder Instability | Shoulder Surgeon

  https://drmillett.com/dislocated-shoulder-and-shoulder-instability/

  On the other hand, older people (40 years of age and older) who experiences a traumatic dislocation will only have a 10% chance of developing chronic instability in future years, but they have an increasing risk of tearing the rotator cuff when the shoulder dislocates and that injury may need treatment in addition to the dislocation. […] This fracture—which is the most common cause of recurrent instability for young adults after an injury—indicates that the ligaments in the front of the shoulder are no longer attached to the glenoid. […] Another common finding is a Hill Sachs fracture, which is an indentation or impression fracture on the ball of the upper arm (proximal humerus) that occurs when it impacts the socket during the dislocation. […] Depending on the cause of the instability, arthroscopic surgery is the most preferred option.

• #61 Dislocated Shoulder | Kenneth Bramlett, MD

  https://kennethbramlettmd.com/dislocated-shoulder/

  What is a dislocated shoulder? […] A dislocation of the acromioclavicular joint is a separated shoulder, a dislocation of the sternoclavicular joint is the interruption of the clavicle and the breast bone, and a dislocation of the glenohumeral joint is when the top part of the humerus (humeral head) is misaligned from the glenoid surface. […] Shoulder dislocations commonly occur from falls, direct blows to the shoulder, trauma, seizures, or electric shock. […] Other shoulder pathology such as a glenoid labral tear can put you at risk for a shoulder dislocation even when performing normal activities as the labrum acts as an internal stabilizer. […] The initial treatment for a shoulder dislocation is reduction, which is putting the humeral head back in the glenoid socket. […] Further surgery may be needed if instability continues or any other ligament injury is diagnosed with a CT scan or MRI. […] Shoulder dislocations in young people are more serious than in the over 60 group as they are more prone to have traumatic ligament injuries.

• #62 Shoulder Dislocation – Sports Clinic NQ

  https://sportsclinicnq.com.au/shoulder-dislocation/

  If you are under 20, your likelihood of re-dislocation is extremely high. Published studies range between 70-100%, but in athletes who are hoping to return to high level contact or throwing sports the rate is actually close to 100%. This is because young people are generally more flexible and have slightly different collagen in their ligaments. If you are under 20 you are more likely to need surgery to stabilize the shoulder so that it doesnt pop back out again you should seriously consider having early surgery after your first dislocation. […] If you are over 40, the likelihood of re-dislocation is quite low. When you are over 40 you are more likely to tear the tissue rather than stretch it and more likely to develop scar tissue. This may leave you with a stiff shoulder rather than one that will continually pop back out.

• #63 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Historically, we have lumped two main patient groups together based on those that have stable shoulders and those that have unstable shoulders. Those that have stable shoulders who dislocate their shoulder are described as having a T.U.B.S. type of pathology. This stands for Traumatic, Unilateral, Bankart lesion and Surgery. To breakdown this acronym, individuals who dislocate their shoulder typically have a violent mechanism of injury if they have a normally stable shoulder. The mechanism of injury is typically one of external rotation and abduction of the arm, where it goes up towards the side. This position would be frequently encountered in a thrower. […] The U stands for Unilateral, in that most patients only experience this on one side of their body. Most dislocations go in an anterior direction. So the U can also mean unidirectional. The B refers to a Bankart lesion which is a term applied to a tear of the labrum or fibrocartilage, typically at the bottom of the socket. The labrum is torn as the ball violently exits the socket. The S part of the acronym accounts for Surgery in that there is high level evidence that individuals who have glenohumeral dislocations have a better prognosis if they have stabilization surgery early in their course. Not all jurisdictions practice this way, however.

• #64 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Another large group of shoulder dislocators are those who are described as having A.M.B.R.I. types of instability. The A refers to Atraumatic in that the shoulder can pop out of joint with very little force. The M stands for Multidirectional where the patients often have excessive motion forward, inferiorly, as well as backward. This is called multidirectional glenohumeral laxity. The B stands for Bilaterality indicating that this is something that happens to both shoulder joints. The R stands for Rehabilitation as these people do not fare as well with shoulder surgery. The I stands for Intensive rehabilitation which is often required in these individuals, and Inferior capsular shift, one of the historical operations in this group of patients. […] In general, when an individual dislocates their shoulder, they require expert medical help relocating it. An x-ray needs to be done to confirm the pathology. Traction on the arm with some external rotation to the hand is typically required to relocate the joint. Counter traction has to be applied through the armpit. The use of medications that can relax an individual such as Midazolam greatly facilitate the reduction process, and this has to be administered in the Emergency Room.

• #65 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Historically, we have lumped two main patient groups together based on those that have stable shoulders and those that have unstable shoulders. Those that have stable shoulders who dislocate their shoulder are described as having a T.U.B.S. type of pathology. This stands for Traumatic, Unilateral, Bankart lesion and Surgery. To breakdown this acronym, individuals who dislocate their shoulder typically have a violent mechanism of injury if they have a normally stable shoulder. The mechanism of injury is typically one of external rotation and abduction of the arm, where it goes up towards the side. This position would be frequently encountered in a thrower. […] The U stands for Unilateral, in that most patients only experience this on one side of their body. Most dislocations go in an anterior direction. So the U can also mean unidirectional. The B refers to a Bankart lesion which is a term applied to a tear of the labrum or fibrocartilage, typically at the bottom of the socket. The labrum is torn as the ball violently exits the socket. The S part of the acronym accounts for Surgery in that there is high level evidence that individuals who have glenohumeral dislocations have a better prognosis if they have stabilization surgery early in their course. Not all jurisdictions practice this way, however.

• #66 Shoulder dislocation | PPT

  https://www.slideshare.net/slideshow/shoulder-dislocation-250126695/250126695

  Posterior dislocation typically occurs due to indirect trauma, with the shoulder in a position of adduction, flexion, and internal rotation. Electric shock or convulsion mechanisms may produce posterior dislocation. […] Inferior glenohumeral dislocation, also known as Luxatio erecta, is very rare and more common in elderly individuals. It results from a hyperabduction force causing impingement of the neck of the humerus on the acromion, which levers the humeral head out inferiorly. […] Recurrent shoulder dislocation is associated with younger age groups, repetitive microtrauma, and poor compliance with rehabilitation programs. The classification includes TUBS (Traumatic, Unidirectional, frequently associated with Bankart lesion) and AMBRI (Atraumatic, Multidirectional, and Bilateral). […] The treatment for recurrent shoulder dislocation includes capsular reattachment procedures, subscapularis tightening procedures, and bony procedures to augment the bony defect. Bankart repair involves reattachment of the antero-inferior glenoid labrum and IGHL back to the glenoid anatomically.

• #67 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Historically, we have lumped two main patient groups together based on those that have stable shoulders and those that have unstable shoulders. Those that have stable shoulders who dislocate their shoulder are described as having a T.U.B.S. type of pathology. This stands for Traumatic, Unilateral, Bankart lesion and Surgery. To breakdown this acronym, individuals who dislocate their shoulder typically have a violent mechanism of injury if they have a normally stable shoulder. The mechanism of injury is typically one of external rotation and abduction of the arm, where it goes up towards the side. This position would be frequently encountered in a thrower. […] The U stands for Unilateral, in that most patients only experience this on one side of their body. Most dislocations go in an anterior direction. So the U can also mean unidirectional. The B refers to a Bankart lesion which is a term applied to a tear of the labrum or fibrocartilage, typically at the bottom of the socket. The labrum is torn as the ball violently exits the socket. The S part of the acronym accounts for Surgery in that there is high level evidence that individuals who have glenohumeral dislocations have a better prognosis if they have stabilization surgery early in their course. Not all jurisdictions practice this way, however.

• #68 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Another large group of shoulder dislocators are those who are described as having A.M.B.R.I. types of instability. The A refers to Atraumatic in that the shoulder can pop out of joint with very little force. The M stands for Multidirectional where the patients often have excessive motion forward, inferiorly, as well as backward. This is called multidirectional glenohumeral laxity. The B stands for Bilaterality indicating that this is something that happens to both shoulder joints. The R stands for Rehabilitation as these people do not fare as well with shoulder surgery. The I stands for Intensive rehabilitation which is often required in these individuals, and Inferior capsular shift, one of the historical operations in this group of patients. […] In general, when an individual dislocates their shoulder, they require expert medical help relocating it. An x-ray needs to be done to confirm the pathology. Traction on the arm with some external rotation to the hand is typically required to relocate the joint. Counter traction has to be applied through the armpit. The use of medications that can relax an individual such as Midazolam greatly facilitate the reduction process, and this has to be administered in the Emergency Room.

• #69 Shoulder dislocation | PPT

  https://www.slideshare.net/slideshow/shoulder-dislocation-250126695/250126695

  Posterior dislocation typically occurs due to indirect trauma, with the shoulder in a position of adduction, flexion, and internal rotation. Electric shock or convulsion mechanisms may produce posterior dislocation. […] Inferior glenohumeral dislocation, also known as Luxatio erecta, is very rare and more common in elderly individuals. It results from a hyperabduction force causing impingement of the neck of the humerus on the acromion, which levers the humeral head out inferiorly. […] Recurrent shoulder dislocation is associated with younger age groups, repetitive microtrauma, and poor compliance with rehabilitation programs. The classification includes TUBS (Traumatic, Unidirectional, frequently associated with Bankart lesion) and AMBRI (Atraumatic, Multidirectional, and Bilateral). […] The treatment for recurrent shoulder dislocation includes capsular reattachment procedures, subscapularis tightening procedures, and bony procedures to augment the bony defect. Bankart repair involves reattachment of the antero-inferior glenoid labrum and IGHL back to the glenoid anatomically.

• #70 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Another large group of shoulder dislocators are those who are described as having A.M.B.R.I. types of instability. The A refers to Atraumatic in that the shoulder can pop out of joint with very little force. The M stands for Multidirectional where the patients often have excessive motion forward, inferiorly, as well as backward. This is called multidirectional glenohumeral laxity. The B stands for Bilaterality indicating that this is something that happens to both shoulder joints. The R stands for Rehabilitation as these people do not fare as well with shoulder surgery. The I stands for Intensive rehabilitation which is often required in these individuals, and Inferior capsular shift, one of the historical operations in this group of patients. […] In general, when an individual dislocates their shoulder, they require expert medical help relocating it. An x-ray needs to be done to confirm the pathology. Traction on the arm with some external rotation to the hand is typically required to relocate the joint. Counter traction has to be applied through the armpit. The use of medications that can relax an individual such as Midazolam greatly facilitate the reduction process, and this has to be administered in the Emergency Room.

• #71 Atraumatic Shoulder Instability | UW Orthopaedic Surgery and Sports Medicine

  https://orthop.washington.edu/patient-care/articles/shoulder/atraumatic-shoulder-instability.html

  A shoulder that has been stable may become unstable after a minor injury or a period of disuse. […] Any of these factors individually or in combination could contribute to instability of the glenohumeral joint. For example posterior glenohumeral subluxation may result from the combination of a relatively flat posterior glenoid and the tendency to retract the scapula during anterior elevation of the arm resulting in use of the elevated humerus in anterior scapular planes. […] Pathogenetic factors such as a flat glenoid weak muscles and a compliant capsule may produce instability anteriorly inferiorly posteriorly or a combination. […] Many patients with the AMBRII syndrome have simply become deconditioned from their normal state of dynamic glenohumeral stability. They have lost the proper neuromuscular control of humeroscapular positioning; concavity compression has become dysfunctional.

• #72 Dislocated shoulder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dislocated-shoulder/symptoms-causes/syc-20371715

  Complications of a dislocated shoulder might include: Tearing of the muscles, ligaments and tendons that reinforce the shoulder joint, Nerve or blood vessel damage in or around the shoulder joint, Becoming more prone to repeat dislocations, especially if the injury is severe. […] Having a dislocated shoulder joint can increase the risk of future shoulder dislocations. To help avoid a recurrence, keep doing the strength and stability exercises prescribed for the injury.

• #73 Dislocated Shoulder: Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17746-dislocated-shoulder

  The upper arm bone, or humerus, is dislocated from the socket in the shoulder blade or scapula. […] A shoulder dislocation is an injury that happens when the ball and socket connection between your bones is separated. It can also damage the tissue around your shoulder joint, including your: Muscles. Nerves. Tendons. Ligaments. Blood vessels. […] Any force thats strong enough to push your shoulder joint out of place can cause a dislocation. The most common causes include: Falls. Car accidents. Sports injuries. […] The most common complications of shoulder dislocation are damage to the bones and tissues around your shoulder, including: Bone fractures. Ligament and tendon sprains. Nerve damage. Damaged blood vessels. Muscle strains. […] A dislocated shoulder wont heal on its own, and it wont heal properly unless a healthcare provider diagnoses and treats it. […] A dislocated shoulder happens when something forces the ball-shaped head of your upper arm bone out of the socket in your shoulder blade. Falls, sports accidents and other trauma usually cause dislocated shoulders. Shoulders are the most commonly dislocated joint.

• #74 Dislocated shoulder – Wikipedia

  https://en.wikipedia.org/wiki/Dislocated_shoulder

  Damage to the axillary artery and axillary nerve (C5, C6) may result. The axillary nerve is injured in 37% making it the most commonly injured structure with this type of injury. Other common, associated, nerve injuries include injury to the suprascapular nerve (29%) and the radial nerve (22%). […] Inferior dislocation is the least likely, occurring in less than 1%. This condition is also called luxatio erecta because the arm appears to be permanently held upward or behind the head. It is caused by a hyper abduction of the arm that forces the humeral head against the acromion. Such injuries have a high complication rate as many vascular, neurological, tendon, and ligament injuries are likely to occur from this mechanism of injury. […] Shoulder reduction may be accomplished with a number of techniques including traction-countertraction, external rotation, scapular manipulation, Stimson technique, Cunningham technique, or Milch technique. Pain can be managed during the procedures either by procedural sedation and analgesia or injected lidocaine into the shoulder joint.

• #75 Dislocated Shoulder: Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17746-dislocated-shoulder

  The upper arm bone, or humerus, is dislocated from the socket in the shoulder blade or scapula. […] A shoulder dislocation is an injury that happens when the ball and socket connection between your bones is separated. It can also damage the tissue around your shoulder joint, including your: Muscles. Nerves. Tendons. Ligaments. Blood vessels. […] Any force thats strong enough to push your shoulder joint out of place can cause a dislocation. The most common causes include: Falls. Car accidents. Sports injuries. […] The most common complications of shoulder dislocation are damage to the bones and tissues around your shoulder, including: Bone fractures. Ligament and tendon sprains. Nerve damage. Damaged blood vessels. Muscle strains. […] A dislocated shoulder wont heal on its own, and it wont heal properly unless a healthcare provider diagnoses and treats it. […] A dislocated shoulder happens when something forces the ball-shaped head of your upper arm bone out of the socket in your shoulder blade. Falls, sports accidents and other trauma usually cause dislocated shoulders. Shoulders are the most commonly dislocated joint.

• #76 Dislocated Shoulder | We Treat Shoulder Dislocations in Children

  https://medicalcitykidsortho.com/dislocated-shoulder/

  The procedure to put the shoulder bone back into place is the most common one for doctors to treat. Your doctor may try some gentle maneuvers to get your child’s shoulder bones back into place. […] When a child dislocates their shoulder, they may tear ligaments, tendons, and other tissues. If these tissues are damaged, our doctors will in some cases consider surgery to repair them. […] Dislocating your shoulder can lead to various complications, affecting the surrounding bones and tissues. Common complications include: Bone Fractures: The force of the dislocation can cause fractures in the shoulder bones. Ligament and Tendon Sprains: These tissues may be overstretched or torn during the dislocation. Nerve Damage: The trauma can impact nerves around the shoulder, potentially causing numbness or weakness. Damaged Blood Vessels: Blood vessels can be injured, leading to circulation issues. Muscle Strains: Muscles around the shoulder may be strained as they try to stabilize the joint. […] A dislocated shoulder will feel unstable or dislocated again. Furthermore, with each subsequent injury, the shoulder becomes easier to dislocate.

• #77 Shoulder Dislocation – Treatment, Management, Exercise – Brisbane Physiotherapy & Podiatry

  https://www.brisbanephysiotherapy.com/news/dislocated-shoulder

• #78 DISLOCATED SHOULDER | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/shoulder-dislocations

  The most common problem is recurrence of the dislocation because the tendons within the joint might have been torn. Some patients can experience recurrence simply by being bumped while hanging onto a handrail during a bus ride or just sleeping with their arm on their forehead. Once a shoulder has been dislocated, surgery may be necessary to repair the torn ligaments to prevent frequent recurrent episodes. […] Other than the bruised or torn tendons within the joint, other pathological manifestation of shoulder dislocation includes tears to the surrounding tissues, cracked in the front bone socket, or torn ligaments around the shoulder. This is why arthroscopic shoulder surgery plays a big role in evaluating the extent of injury in full HD as well as allowing repair sutures. […] If left untreated, dislocated shoulder can cause more damages to the head of the bone, the bone socket, and surrounding tissues.

• #79 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  Impression fractures of the humeral head (Hill-Sachs lesions) can be observed in up to 93 % of first-time cases of shoulder dislocation. […] The extent of the bone loss on the glenoid must be seen in conjunction with the size and location of the Hill-Sachs lesion. Computed tomography (CT) with three-dimensional imaging is an important aid for identifying and evaluating bone damage in the shoulder, particularly in patients with recurrent dislocations. […] Young people (30 years) and active patients should be considered for surgery as the risk of recurrent dislocations is high. Surgical stabilisation at an early stage can prevent further damage to shoulder stabilising structures. […] A wait-and-see approach and repeated episodes of instability can cause further injury to the stabilising structures, including increased bone loss. The loss of function in cases of repeated episodes of instability is not well documented, but the aforementioned meta-analysis indicated that young patients and individuals who rely heavily on their shoulders to perform can benefit from surgical stabilisation after first-time shoulder dislocation, particularly where bone loss has been established and a high function level is needed, such as in contact sports.

• #80

  https://www.ijoro.org/index.php/ijoro/article/view/3492

  Patients with chronic shoulder instability are more likely to have secondary intra-articular lesions, compared to those with acute, likely due to the repeated episodes of dislocation or subluxation. These associated lesions are a consequence of the ongoing instability, which leads to additional damage within the joint. Early intervention plays an important role, as the conditions for surgical intervention are optimal after initial shoulder dislocation.

• #81 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  Impression fractures of the humeral head (Hill-Sachs lesions) can be observed in up to 93 % of first-time cases of shoulder dislocation. […] The extent of the bone loss on the glenoid must be seen in conjunction with the size and location of the Hill-Sachs lesion. Computed tomography (CT) with three-dimensional imaging is an important aid for identifying and evaluating bone damage in the shoulder, particularly in patients with recurrent dislocations. […] Young people (30 years) and active patients should be considered for surgery as the risk of recurrent dislocations is high. Surgical stabilisation at an early stage can prevent further damage to shoulder stabilising structures. […] A wait-and-see approach and repeated episodes of instability can cause further injury to the stabilising structures, including increased bone loss. The loss of function in cases of repeated episodes of instability is not well documented, but the aforementioned meta-analysis indicated that young patients and individuals who rely heavily on their shoulders to perform can benefit from surgical stabilisation after first-time shoulder dislocation, particularly where bone loss has been established and a high function level is needed, such as in contact sports.

• #82 Shoulder Dislocation : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/shoulder-dislocation/

  97% of shoulder dislocations are anteriorly located. […] >90% of anterior shoulder dislocations are reducible in the ED. […] Prior history of shoulder dislocation predisposes patients to repeat dislocations of the same joint. […] Delays in shoulder reduction can decrease reduction success rates. […] Pain management promotes muscle relaxation which can improve success rates and decrease reduction times. […] Slow, gradual reduction maneuvers are important in minimizing axillary nerve complications. […] Anterior Dislocation (97% of cases) […] Mechanism of injury involving excessive external rotation while abducted. […] Posterior Dislocation (2% of cases) […] Mechanism of injury involves electrical shock, tonic-clonic seizure, or trauma. […] Inferior Dislocation (< 1% of cases, Luxatio Erecta)

• #83 Posterior Shoulder Dislocation • LITFL • Trauma Library

  https://litfl.com/posterior-shoulder-dislocation/

  An impaction fracture of the anteromedial aspect of the humeral head (McLaughin lesion or reverse Hill-Sachs lesion) may result from the humerus being forced against the posterior lip of the glenoid. […] If enlocation is delayed, it can worsen the severity of this lesion and lead to further complications. Dislocation may also result in capsulolabral tears, glenoid rim fractures or rotator cuff tears. […] When a bilateral posterior dislocation is present, it is almost always secondary to seizure activity. With seizure activity, the internal rotator muscles (teres major and subscapularis) overpower the external rotator muscles (teres minor, infraspinatus) to dislocate the head of humerus. […] A posterior dislocation should be considered as a differential in any episode of shoulder pain and immobility after a seizure.

• #84 Posterior Shoulder Dislocations | Orthopedic Center for Sports Medicine

  https://nolasportsmedicine.com/posterior-shoulder-dislocations/

  Open reduction is indicated in dislocations in which a closed reduction cannot be achieved such as in cases where defects to the humeral head articular surface ranges from 25% to 45%. If the injury is less than 3 weeks old, disimpaction and bone grafting of the defect can be performed. In the case of larger defects of up to 50% and young patients with viable humeral bone reserve, fixation of the allografts in defective areas with partially threaded cancellous screws yielded excellent results. […] Some complications are: Chronic shoulder pain, Recurrent instability, Avascular necrosis, Non-union, Chronic stiffness, Nerve damage, Rotator cuff injuries, Osteoarthritis of the shoulder, Allograft collapse. […] The functional outcomes depend mainly on the duration of the dislocation and the extent of the articular injury. In shoulder dislocations not associated with a fracture, other injuries or in younger patients the shoulder should be kept immobilized for two to three weeks. In the elderly, this time frame may shrink to only a week because the risk of developing frozen shoulder (a joint that becomes totally immobile) is markedly increased. Physical therapy is necessary for rotator cuff strengthening, periscapular stabilization and to return normal function to the shoulder joint. Therapy may include exercises to strengthen the muscles that surround the shoulder and to maintain range of motion of the shoulder joint. The total rehabilitation and recovery time from a shoulder dislocation is about 12-16 weeks.

• #85 Posterior Shoulder Dislocation • LITFL • Trauma Library

  https://litfl.com/posterior-shoulder-dislocation/

  Posterior shoulder dislocations make up a small minority of total shoulder dislocation cases, accounting for 2-4% of presentations. However because of a low level of clinical suspicion and insufficient imaging, they are often missed. […] Approximately half of posterior shoulder dislocations go undiagnosed on initial presentation. […] Traditionally posterior dislocations have been associated with epileptic seizures, high energy trauma, electrocution and electroconvulsive therapy (ECT), although the incidence associated with ECT especially has decreased somewhat in recent years. […] In traumatic posterior dislocations, the injury is almost always due to a fall onto an outstretched, internally rotated arm. The force of the impact pushes the head of the humerus posteriorly out of the glenoid cavity.

• #86 Posterior Shoulder Dislocations | Orthopedic Center for Sports Medicine

  https://nolasportsmedicine.com/posterior-shoulder-dislocations/

  Patients with posterior shoulder instability frequently report aching pain and weakness along the posterior or anterior joint line, the biceps tendon, and/or the superior aspect of the rotator cuff. Symptoms intensify with the arm in 90 forward flexion, adduction (close to the body), and internal rotation (reaching back). Dislocations may also cause numbness, weakness or tingling near the injury, such as in your neck or down your arm. The muscles in your shoulder may spasm from the disruption, often increasing the intensity of your pain. When the shoulder dislocates posteriorly the capsule, ligaments and labrum may tear causing increasing pain and restricted motion. […] Diagnosis is often delayed and this leads to a locked posteriorly dislocated humeral head. Plain X-rays may be taken to confirm the diagnosis of shoulder dislocation and to make certain there are no fractures associated with the dislocation. Severe edema after the injury hinders the diagnosis so the clinical examination must be done carefully. During physical examination the anterior aspect of the shoulder may seem to be flattened and the patient may present with pain at both the anterior and the posterior aspects of the shoulder region with limited range of motion, especially in abduction and external rotation (away from the body). Clinical picture may resemble other shoulder pathologies such as frozen shoulder, shoulder sprain or a rotator cuff tear. In up to 79% of cases, the diagnosis is made only once the injury has become chronic and the shoulder has been locked, which unfortunately has a negative effect on prognosis.

• #87 Dislocated Shoulder: Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17746-dislocated-shoulder

  The upper arm bone, or humerus, is dislocated from the socket in the shoulder blade or scapula. […] A shoulder dislocation is an injury that happens when the ball and socket connection between your bones is separated. It can also damage the tissue around your shoulder joint, including your: Muscles. Nerves. Tendons. Ligaments. Blood vessels. […] Any force thats strong enough to push your shoulder joint out of place can cause a dislocation. The most common causes include: Falls. Car accidents. Sports injuries. […] The most common complications of shoulder dislocation are damage to the bones and tissues around your shoulder, including: Bone fractures. Ligament and tendon sprains. Nerve damage. Damaged blood vessels. Muscle strains. […] A dislocated shoulder wont heal on its own, and it wont heal properly unless a healthcare provider diagnoses and treats it. […] A dislocated shoulder happens when something forces the ball-shaped head of your upper arm bone out of the socket in your shoulder blade. Falls, sports accidents and other trauma usually cause dislocated shoulders. Shoulders are the most commonly dislocated joint.

• #88 Dislocated Shoulder | We Treat Shoulder Dislocations in Children

  https://medicalcitykidsortho.com/dislocated-shoulder/

  A dislocated shoulder in children occurs when the upper arm bone (humerus) pops out of the shoulder socket (glenoid). This displacement results in a partial (subluxation) or complete dislocation. Dislocations usually result from a significant force or trauma, such as a fall on an outstretched arm, a collision during sports, or a direct blow to the shoulder. […] A fall or blow to the shoulder can cause a shoulder dislocation. This can occur during sporting events. Shoulder dislocations appear more common in teenagers than in younger children. […] No, a dislocated shoulder cannot fix itself. When this injury occurs, the shoulder joint is forced out of its normal position, and without proper intervention, it won’t realign correctly on its own. […] A healthcare professional needs to assess the extent of the dislocation. A comprehensive evaluation may include physical examination and imaging tests to determine any additional damage, such as ligament tears or fractures.

• #89 Mechanisms of traumatic shoulder injury in elite rugby players | British Journal of Sports Medicine

  https://bjsm.bmj.com/content/46/7/538

  Shoulder injuries in rugby players are common, but the mechanisms of injury are less well understood. This study aims to elucidate common mechanisms of injury and identify the patterns of injury they produce. The authors identified three mechanisms of shoulder injury from the video analysis. These are the Try-Scorer, characterised by hyperflexion of the outstretched arm such as when scoring a try; the Tackler, extension of the abducted arm behind the player while tackling; and the Direct Impact, a direct blow to the arm or shoulder when held by the side in neutral or slight adduction. The Try Scorer and Tackler mechanisms both involve a levering force on the glenohumeral joint (GHJ). These mechanisms predominantly cause GHJ dislocation, with Bankart, reverse Bankart and superior labrum anteriorposterior tears. The Try-Scorer Mechanism also caused the majority (83%) of rotator cuff tears. The Direct Hit mechanism resulted in GHJ dislocation and labral injury in 37.5% of players and was most likely to cause acromioclavicular joint dislocation and scapula fractures, injuries that were not seen with the other mechanisms. Greater understanding of the mechanisms involved in rugby shoulder injury is useful in understanding the pathological injuries, guiding treatment and rehabilitation and aiding the development of injury-prevention methods.

• #90 Shoulder Injuries – Gymnastics Medicine

  https://gymnasticsmedicine.org/shoulder/

  Mechanism of Injury/Description: This injury can result from a fall or landing with your arm out to the side and rotated. In most cases, the shoulder is abducted and externally rotated at the time of the injury, meaning it has gone beyond the regular rotation, thus resulting in a partial dislocation (subluxation) or complete dislocation. […] Diagnosis: A dislocation is determined by the history and physical exam (positive apprehension test) and an MRI often shows the extent of the injury, including a labrum tear, bone bruising, Hill-Sachs lesion and Bankart lesions). […] Treatment: In the case of a true dislocation, the gymnast should seek immediate medical attention for the shoulder to be set back. However, if it is a partial dislocation, also known as a subluxation, the injury may be less severe but does still require the gymnast to be seen by a Medical Provider. Rest, anti-inflammatory medications, and physical therapy are important in the recovery in a subluxation episode. Your Medical Provider will determine if surgical intervention is needed (which is usually the case in true dislocations as this typically causes a labrum tear).

• #91 Mechanisms of traumatic shoulder injury in elite rugby players | British Journal of Sports Medicine

  https://bjsm.bmj.com/content/46/7/538

  Shoulder injuries in rugby players are common, but the mechanisms of injury are less well understood. This study aims to elucidate common mechanisms of injury and identify the patterns of injury they produce. The authors identified three mechanisms of shoulder injury from the video analysis. These are the Try-Scorer, characterised by hyperflexion of the outstretched arm such as when scoring a try; the Tackler, extension of the abducted arm behind the player while tackling; and the Direct Impact, a direct blow to the arm or shoulder when held by the side in neutral or slight adduction. The Try Scorer and Tackler mechanisms both involve a levering force on the glenohumeral joint (GHJ). These mechanisms predominantly cause GHJ dislocation, with Bankart, reverse Bankart and superior labrum anteriorposterior tears. The Try-Scorer Mechanism also caused the majority (83%) of rotator cuff tears. The Direct Hit mechanism resulted in GHJ dislocation and labral injury in 37.5% of players and was most likely to cause acromioclavicular joint dislocation and scapula fractures, injuries that were not seen with the other mechanisms. Greater understanding of the mechanisms involved in rugby shoulder injury is useful in understanding the pathological injuries, guiding treatment and rehabilitation and aiding the development of injury-prevention methods.

• #92 Mechanisms of traumatic shoulder injury in elite rugby players | British Journal of Sports Medicine

  https://bjsm.bmj.com/content/46/7/538

  Though the shoulder injuries sustained in rugby have been described previously, the specific mechanisms that cause the injuries are less well understood. Understanding the exact mechanistic cause would aid the understanding of the injuries and assist with injury prevention. The aims of this study are to elucidate and describe patterns of shoulder injury mechanism in elite rugby players and to correlate injury-producing mechanisms with specific patterns of injury. […] Three mechanisms of injury were identified. The first is termed Try Scorer, as the mechanism occurred commonly while diving and reaching the ball-carrying hand forward to score a try. A posterior force drives the arm backwards and exerts leverage on the glenohumeral joint with the arm either remaining in fixed flexion by contact with the ground, or forced into further flexion. The second mechanism is termed Tackler, seen in four players. A posteriorly directed force, resulting from contact with the ball-carrying player for example, extends the abducted arm behind the player in the plane of abduction, again exerting a levering force on the glenohumeral joint. The third mechanism is termed Direct Impact and was seen in eight players. A medially directed compressive force caused by direct impact to the shoulder results in injury.

• #93 Shoulder Injuries – Gymnastics Medicine

  https://gymnasticsmedicine.org/shoulder/

  Mechanism of Injury/Description: This injury can result from a fall or landing with your arm out to the side and rotated. In most cases, the shoulder is abducted and externally rotated at the time of the injury, meaning it has gone beyond the regular rotation, thus resulting in a partial dislocation (subluxation) or complete dislocation. […] Diagnosis: A dislocation is determined by the history and physical exam (positive apprehension test) and an MRI often shows the extent of the injury, including a labrum tear, bone bruising, Hill-Sachs lesion and Bankart lesions). […] Treatment: In the case of a true dislocation, the gymnast should seek immediate medical attention for the shoulder to be set back. However, if it is a partial dislocation, also known as a subluxation, the injury may be less severe but does still require the gymnast to be seen by a Medical Provider. Rest, anti-inflammatory medications, and physical therapy are important in the recovery in a subluxation episode. Your Medical Provider will determine if surgical intervention is needed (which is usually the case in true dislocations as this typically causes a labrum tear).

• #94 Shoulder dislocation

  https://fittoplay.org/body-parts/shoulder/shoulder-dislocation/

  The shoulder joint has the greatest range of motion compared to any other joint in the body. This makes it less stable, and susceptible to dislocations. […] Shoulder dislocations often occur in connection with sports. The most common cause is falling on an outstretched arm, or that the arm experiences an external impact while it is facing outwards and upwards (a so-called outward rotation of an abducted arm). An example of this is when a handball player is tackled by an opponent while shooting on goal. […] When the shoulder dislocates in a forward direction, it is mainly because the surrounding muscles fail to keep the shoulder joint in place when it is subjected to heavy forces. When this happens, it tends to damage the joint capsule, labrum (a cartilage rim in the shoulder), and ligaments. There might also be minor fractures in the top of the upper arm (humeral head).

• #95 Posterior Shoulder Dislocations | Orthopedic Center for Sports Medicine

  https://nolasportsmedicine.com/posterior-shoulder-dislocations/

  The anatomic configuration of the shoulder joint known as the glenohumeral joint is often compared to a golf ball on a tee. It is the most mobile joint in the body allowing the arm to move in many directions which is why it is the most frequently dislocated joint in the human body. The stability and movement at the shoulder is controlled by the rotator cuff muscles, ligaments, and the capsulolabral complex of the shoulder. There are three main types of dislocations depending on displacement direction of the humeral head: anterior, inferior and posterior. Posterior dislocations also known as Reverse Hill-Sachs lesion are those in which the humeral head has moved backward toward the shoulder blade and they attribute to 4% of all shoulder dislocations. […] Dislocations of the shoulder occur when the head of the humerus is forcibly removed from its socket in the glenoid fossa. The most common cause for posterior dislocations is anterior trauma to the shoulder such as blunt force. Seizures (epileptic, hypoglycemic, drug-induced, etc.) or electric shocks such as being hit by lightning or being electrocuted can also cause unilateral or bilateral posterior dislocations due to unbalanced muscle contractions pulling the humeral head backwards. Sport activities that may lead to posterior shoulder instability include heavy bench pressing and football linemen blocking. Other sports where this type of dislocation is commonly seen are basketball and volleyball.

• #96 Mechanisms of traumatic shoulder injury in elite rugby players | British Journal of Sports Medicine

  https://bjsm.bmj.com/content/46/7/538

  Three mechanisms of shoulder injury in rugby players have been identified from this study. These are the Try Scorer, comprising hyperflexion of the outstretched arm leading to glenohumeral dislocation, labral injuries and rotator cuff tears; the Tackler, comprising extension of the abducted arm resulting in dislocation and labral injuries; and the Direct Impact, comprising a compressive force to adducted, internally rotated arm resulting in acromioclavicular injury, scapula fractures and, less commonly, glenohumeral dislocation. Greater understanding of the mechanisms involved in shoulder injury in rugby players is useful both for understanding how injuries occur and also to guide the rehabilitation and injury-prevention processes.

• #97 Shoulder Dislocation

  https://mobile.fpnotebook.com/Ortho/Shoulder/ShldrDslctn.htm

  The Shoulder joint is unstable by nature. The shallow glenoid fossa articulates only 20-30% of the humeral head. Requires ligamentous (e.g. labrum) and tendons (rotator cuff) for stability. […] Result of high energy mechanism with exaggerated abduction, tearing the inferior capsule and labrum. Axial loading of a fully abducted arm OR Hyperabduction force to the arm.

• #98 Shoulder Dislocation – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/dislocated-shoulder/

  The shoulder joint is the most mobile joint in the human body. It can turn in many directions, allowing us to position our hands in multiple positions. However, this advantage also makes the shoulder an easy joint to come out of the socket (dislocate). […] Shoulder dislocations can be complete or partial, and usually occur after a trauma, such as a fall or motor vehicle collision. […] Other potential causes of a shoulder dislocation include seizures and electrocutions. Following a seizure, the shoulder often dislocates backward. […] Most commonly, the shoulder dislocates by sliding forward (anterior) out of the socket. This occurs when the shoulder dislocates while the arm is raised away from the body. […] The shoulder is stable because of the combined stabilizing effects of bone surfaces, ligaments, and muscles. When a shoulder dislocates, any or all of these structures can be injured to different degrees.

• #99 Shoulder Dislocation

  https://mobile.fpnotebook.com/Ortho/Shoulder/ShldrDslctn.htm

  The Shoulder joint is unstable by nature. The shallow glenoid fossa articulates only 20-30% of the humeral head. Requires ligamentous (e.g. labrum) and tendons (rotator cuff) for stability. […] Result of high energy mechanism with exaggerated abduction, tearing the inferior capsule and labrum. Axial loading of a fully abducted arm OR Hyperabduction force to the arm.

• #100 Dislocated Shoulder – South Carolina Sports Medicine and Orthopaedic Center – Charleston, SC

  https://scsportsmedicine.com/sports-medicine-charleston-sc/shoulder-surgery-charleston-sc/dislocated-shoulder

  At our specialized facility in Charleston, SC, our physicians are trained to treat problems on a case by case basis. […] The shoulder is actually several joints, the main joint, the glenohumeral joint (which is most frequently dislocated) has the greatest range of motion of all joints in the body. […] There are several loose ligaments that form the shoulder capsule. These ligaments are attached to both the humeral head and glenoid. Each ligament tightens in different arm positions, thus keeping the humeral head attached to the glenoid. These ligaments are responsible for static stability. Rotator cuff muscles that originate on the scapula (wing bone) form a cuff of tendons that surround the humeral head. These rotator cuff muscles and tendons provide for dynamic stability of the glenohumeral joint.

• #101 Dislocated Shoulder and Chronic Shoulder Instability | Dr. Gordon Groh

  https://www.drgordongroh.com/orthopaedic-injuries-treatment/shoulder/dislocated-shoulder-and-chronic-shoulder-instability/

  Most shoulder instability however is the result of trauma. […] This is because the ball of the humerus is large and the socket is small on the scapular side think of the small amount of stability a golf ball has on a tee. […] Because of this lack of bone stability, most stability for the shoulder comes from the surrounding soft tissue capsule, labrum, and rotator cuff. […] X-rays may reveal bone changes associated with chronic instability loss of bone stock or avulsion injuries. […] Operative treatment is typically aimed at repairing the capsular and labral tearing associated with instability Bankart lesion. […] Regardless of the approach, repair of the Bankart lesion typically is addressed with sutures and anchors which are inserted into the bone.

• #102 Dislocated Shoulder and Chronic Shoulder Instability | Dr. Gordon Groh

  https://www.drgordongroh.com/orthopaedic-injuries-treatment/shoulder/dislocated-shoulder-and-chronic-shoulder-instability/

  Most shoulder instability however is the result of trauma. […] This is because the ball of the humerus is large and the socket is small on the scapular side think of the small amount of stability a golf ball has on a tee. […] Because of this lack of bone stability, most stability for the shoulder comes from the surrounding soft tissue capsule, labrum, and rotator cuff. […] X-rays may reveal bone changes associated with chronic instability loss of bone stock or avulsion injuries. […] Operative treatment is typically aimed at repairing the capsular and labral tearing associated with instability Bankart lesion. […] Regardless of the approach, repair of the Bankart lesion typically is addressed with sutures and anchors which are inserted into the bone.

• #103 Posterior Shoulder Dislocations | Orthopedic Center for Sports Medicine

  https://nolasportsmedicine.com/posterior-shoulder-dislocations/

  The anatomic configuration of the shoulder joint known as the glenohumeral joint is often compared to a golf ball on a tee. It is the most mobile joint in the body allowing the arm to move in many directions which is why it is the most frequently dislocated joint in the human body. The stability and movement at the shoulder is controlled by the rotator cuff muscles, ligaments, and the capsulolabral complex of the shoulder. There are three main types of dislocations depending on displacement direction of the humeral head: anterior, inferior and posterior. Posterior dislocations also known as Reverse Hill-Sachs lesion are those in which the humeral head has moved backward toward the shoulder blade and they attribute to 4% of all shoulder dislocations. […] Dislocations of the shoulder occur when the head of the humerus is forcibly removed from its socket in the glenoid fossa. The most common cause for posterior dislocations is anterior trauma to the shoulder such as blunt force. Seizures (epileptic, hypoglycemic, drug-induced, etc.) or electric shocks such as being hit by lightning or being electrocuted can also cause unilateral or bilateral posterior dislocations due to unbalanced muscle contractions pulling the humeral head backwards. Sport activities that may lead to posterior shoulder instability include heavy bench pressing and football linemen blocking. Other sports where this type of dislocation is commonly seen are basketball and volleyball.

• #104 Dislocated Shoulder – Connecticut Orthopaedics

  https://www.ct-ortho.com/patient-resources/patient-education/articles/dislocated-shoulder/

  Traumatic shoulder dislocations are the most commonly occurring large joint dislocations. The shoulder is a complex joint composed of the ball, humeral head, and the socket, glenoid. The downside to this freedom of motion is an increased risk of instability. The shoulder can dislocate in any direction, but the most common is an anterior dislocation. Anterior dislocations occur in 97% of cases. Anterior dislocation usually occurs with a posterior directed force on the arm when the shoulder is in an abducted and externally rotated position, similar to the position of the arm when cocking back to throw a ball. […] The shoulder has both static and dynamic restraints that combine to keep the shoulder in a reduced position. The static restraints when an injury occurs cannot be altered without surgery and include the labrum, glenoid, and ligaments. The dynamic stabilizers of the shoulder include the rotator cuff and the scapular stabilizer muscles. When there is an injury to the static restraints of the shoulder the dynamic stabilizers can be utilized to try and overcome the static restraint limitations to provide a stable shoulder. […] The typical injury of the shoulder is a Bankart lesion, which occurs in over 95% of shoulder dislocations, and is a result of a tear of the anterior inferior labrum of the glenoid.

• #105 Dislocated Shoulder – South Carolina Sports Medicine and Orthopaedic Center – Charleston, SC

  https://scsportsmedicine.com/sports-medicine-charleston-sc/shoulder-surgery-charleston-sc/dislocated-shoulder

  At our specialized facility in Charleston, SC, our physicians are trained to treat problems on a case by case basis. […] The shoulder is actually several joints, the main joint, the glenohumeral joint (which is most frequently dislocated) has the greatest range of motion of all joints in the body. […] There are several loose ligaments that form the shoulder capsule. These ligaments are attached to both the humeral head and glenoid. Each ligament tightens in different arm positions, thus keeping the humeral head attached to the glenoid. These ligaments are responsible for static stability. Rotator cuff muscles that originate on the scapula (wing bone) form a cuff of tendons that surround the humeral head. These rotator cuff muscles and tendons provide for dynamic stability of the glenohumeral joint.

• #106 Shoulder dislocation | PPT

  https://www.slideshare.net/slideshow/shoulder-dislocation-250126695/250126695

  Shoulder joint also known as Glenohumeral joint, is a ball and socket type of joint. It is inherently unstable because the Ball is big and the socket is small. Only about one-third of the humeral head is in contact with the glenoid cavity at any one time. Gleno-humoral joint stability depends on both passive and active mechanisms. Passive mechanisms include joint conformity, vacuum effect of limited joint volume, adhesion and cohesion owing to the presence of synovial fluid, scapular inclination, glenoid labrum, bony restraints, and ligamentous and capsular restraints. […] Pathological changes of shoulder dislocations include Bankarts lesion, Hill-sachs lesion, and rotator cuff tear. Anterior dislocation may occur as a result of trauma, with indirect trauma to the upper extremity with the shoulder in abduction, extension, and external rotation being the most common mechanism. Direct trauma involves an anteriorly directed impact to the posterior shoulder.

• #107 Shoulder Dislocation – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/dislocated-shoulder/

  When the head of the humerus dislocates, the glenoid socket and the ligaments in the front of the shoulder are often injured. […] The labrum the cartilage rim around the edge of the glenoid may also tear. This is known as a Bankart lesion. […] In very severe dislocations, such as those that result from motor vehicle accidents, damage to nerves or blood vessels can also occur. […] Some people are born with greater laxity or looseness in their ligaments. These people are at greater risk of dislocating their shoulders. […] People who have had shoulder dislocations in the past also have a high risk of future dislocations and these can happen even without an injury. […] A complete dislocation may tear the ligaments and/or tendons in the shoulder and/or damage nerves. […] The goal of immediate treatment of a dislocated shoulder is to return the elbow to its normal alignment.

• #108 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The commonality of recurrent anterior shoulder dislocations can be attributed to the shoulder anatomy deformities present following initial dislocation. Such injury-caused deformities include abnormal laxity of the joint capsule and surrounding muscles, deformities of the head of the humerus, and contracture of the muscles surrounding the glenohumeral joint. Of note, greater tuberosity fractures have been shown to decrease the risk of recurrent instability in patients who obtained the injury in first-time traumatic anterior shoulder dislocations. Subsequent anterior shoulder dislocations increase the risk of glenoid bone loss, exacerbating the already existent shoulder deformities present after initial injury. An evaluation of 714 athletes found a glenoid bone loss of 6.8% after a first-time anterior shoulder instability event and a total calculated glenoid bone loss of 22.8% in the setting of recurrent instability. A primary study evaluating recurrent dislocations in cases of glenoid bone loss found recurrence rates similar to the rest of the literature, with a 27% rate in patients over 30 and a 72% rate in patients under 23 years old. In addition, more recent studies, including a systematic review and meta-analysis, found that younger patient age, male sex, glenohumeral joint hyperlaxity, higher activity levels, increased pain, and higher levels of reinjury fear also increase the risk of dislocation recurrence.

• #109 Shoulder Dislocations – Dr Neil Craton

  https://neilcraton.com/shoulder-dislocations/

  Shoulder dislocations are more appropriately referred to as glenohumeral dislocations. Glenohumeral dislocations are part of a broad spectrum of shoulder disorders related to instability of this joint. There is no true shoulder joint, but the ball and socket joint called the glenohumeral joint is thought of as the true shoulder joint by most people. The glenoid or socket is very shallow. The anatomic relationship is like a golf ball sitting on a tee. The ball represented by the head of the humerus, and the tee represented by the glenoid of the shoulder blade. The problem is that the tee is placed on its side and angled forward. The glenoid surface is surrounded by a lip of fibrocartilage known as the labrum. This deepens the socket for the humerus and augments stability of this joint. There is significant individual variation in the amount of ligament laxity and consequent movement at this joint. People with generalized ligament laxity, especially young women, tend to have a great deal of potential movement of the ball in the socket. The ball can move freely in most directions, especially forward and inferiorly. Because of muscle imbalance, the ball frequently sits towards the front of the socket, and this is often associated with irritation of the biceps tendon and the infraspinatus muscle of the rotator cuff, located on the back of the shoulder blade.

• #110 Atraumatic Shoulder Instability | UW Orthopaedic Surgery and Sports Medicine

  https://orthop.washington.edu/patient-care/articles/shoulder/atraumatic-shoulder-instability.html

  A shoulder that has been stable may become unstable after a minor injury or a period of disuse. […] Any of these factors individually or in combination could contribute to instability of the glenohumeral joint. For example posterior glenohumeral subluxation may result from the combination of a relatively flat posterior glenoid and the tendency to retract the scapula during anterior elevation of the arm resulting in use of the elevated humerus in anterior scapular planes. […] Pathogenetic factors such as a flat glenoid weak muscles and a compliant capsule may produce instability anteriorly inferiorly posteriorly or a combination. […] Many patients with the AMBRII syndrome have simply become deconditioned from their normal state of dynamic glenohumeral stability. They have lost the proper neuromuscular control of humeroscapular positioning; concavity compression has become dysfunctional.

• #111

  https://www.ijoro.org/index.php/ijoro/article/view/3492

  Patients with chronic shoulder instability are more likely to have secondary intra-articular lesions, compared to those with acute, likely due to the repeated episodes of dislocation or subluxation. These associated lesions are a consequence of the ongoing instability, which leads to additional damage within the joint. Early intervention plays an important role, as the conditions for surgical intervention are optimal after initial shoulder dislocation.

• #112 DISLOCATED SHOULDER | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/shoulder-dislocations

  The most common problem is recurrence of the dislocation because the tendons within the joint might have been torn. Some patients can experience recurrence simply by being bumped while hanging onto a handrail during a bus ride or just sleeping with their arm on their forehead. Once a shoulder has been dislocated, surgery may be necessary to repair the torn ligaments to prevent frequent recurrent episodes. […] Other than the bruised or torn tendons within the joint, other pathological manifestation of shoulder dislocation includes tears to the surrounding tissues, cracked in the front bone socket, or torn ligaments around the shoulder. This is why arthroscopic shoulder surgery plays a big role in evaluating the extent of injury in full HD as well as allowing repair sutures. […] If left untreated, dislocated shoulder can cause more damages to the head of the bone, the bone socket, and surrounding tissues.

• #113 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The commonality of recurrent anterior shoulder dislocations can be attributed to the shoulder anatomy deformities present following initial dislocation. Such injury-caused deformities include abnormal laxity of the joint capsule and surrounding muscles, deformities of the head of the humerus, and contracture of the muscles surrounding the glenohumeral joint. Of note, greater tuberosity fractures have been shown to decrease the risk of recurrent instability in patients who obtained the injury in first-time traumatic anterior shoulder dislocations. Subsequent anterior shoulder dislocations increase the risk of glenoid bone loss, exacerbating the already existent shoulder deformities present after initial injury. An evaluation of 714 athletes found a glenoid bone loss of 6.8% after a first-time anterior shoulder instability event and a total calculated glenoid bone loss of 22.8% in the setting of recurrent instability. A primary study evaluating recurrent dislocations in cases of glenoid bone loss found recurrence rates similar to the rest of the literature, with a 27% rate in patients over 30 and a 72% rate in patients under 23 years old. In addition, more recent studies, including a systematic review and meta-analysis, found that younger patient age, male sex, glenohumeral joint hyperlaxity, higher activity levels, increased pain, and higher levels of reinjury fear also increase the risk of dislocation recurrence.

• #114 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  Impression fractures of the humeral head (Hill-Sachs lesions) can be observed in up to 93 % of first-time cases of shoulder dislocation. […] The extent of the bone loss on the glenoid must be seen in conjunction with the size and location of the Hill-Sachs lesion. Computed tomography (CT) with three-dimensional imaging is an important aid for identifying and evaluating bone damage in the shoulder, particularly in patients with recurrent dislocations. […] Young people (30 years) and active patients should be considered for surgery as the risk of recurrent dislocations is high. Surgical stabilisation at an early stage can prevent further damage to shoulder stabilising structures. […] A wait-and-see approach and repeated episodes of instability can cause further injury to the stabilising structures, including increased bone loss. The loss of function in cases of repeated episodes of instability is not well documented, but the aforementioned meta-analysis indicated that young patients and individuals who rely heavily on their shoulders to perform can benefit from surgical stabilisation after first-time shoulder dislocation, particularly where bone loss has been established and a high function level is needed, such as in contact sports.

• #115 DISLOCATED SHOULDER | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/shoulder-dislocations

  The most common problem is recurrence of the dislocation because the tendons within the joint might have been torn. Some patients can experience recurrence simply by being bumped while hanging onto a handrail during a bus ride or just sleeping with their arm on their forehead. Once a shoulder has been dislocated, surgery may be necessary to repair the torn ligaments to prevent frequent recurrent episodes. […] Other than the bruised or torn tendons within the joint, other pathological manifestation of shoulder dislocation includes tears to the surrounding tissues, cracked in the front bone socket, or torn ligaments around the shoulder. This is why arthroscopic shoulder surgery plays a big role in evaluating the extent of injury in full HD as well as allowing repair sutures. […] If left untreated, dislocated shoulder can cause more damages to the head of the bone, the bone socket, and surrounding tissues.

• #116

  https://www.ijoro.org/index.php/ijoro/article/view/3492

  Patients with chronic shoulder instability are more likely to have secondary intra-articular lesions, compared to those with acute, likely due to the repeated episodes of dislocation or subluxation. These associated lesions are a consequence of the ongoing instability, which leads to additional damage within the joint. Early intervention plays an important role, as the conditions for surgical intervention are optimal after initial shoulder dislocation.

• #117 6 Dislocated Shoulder Facts and Treatment in Maumee

  https://www.promedicaeruc.org/blog/2024/march/6-dislocated-shoulder-facts-and-treatment-in-mau/

  You can handle minor injuries at home, but shoulder dislocations are different. A dislocated shoulder won’t heal on its own, and you could end up with chronic instability without the proper treatment. […] Dislocations are identified based on how the bone moves out of the socket. It can move forward, below or behind the joint. Forward (anterior) movement is the most common. Often, anterior dislocations result from sports injuries or falling on outstretched hands. […] You may need surgery if you have chronic shoulder instability or severe complications from the dislocation. Still, most people fully recover with non-surgical treatment, including putting the bone back in the socket, immobilizing the joint and restoring strength and mobility with physical therapy. […] Because dislocated shoulders hurt so badly, people don’t always realize they also have other injuries. Up to 40% of people diagnosed with anterior dislocation have accompanying injuries resulting from the trauma. There are numerous types of associated injuries you can suffer, with tears, fractures and nerve damage being the most common.

• #118 Shoulder Dislocation – Treatment, Management, Exercise – Brisbane Physiotherapy & Podiatry

  https://www.brisbanephysiotherapy.com/news/dislocated-shoulder

• #119 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  Management strategies for dislocations often include surgical options. For patients under 30, non-surgical treatment has been associated with significantly higher rates of recurrent dislocation outside of young adolescents. One study, over 10 years, determined that conservatively managed patients exhibited a 62% recurrence rate compared with 9% in surgically repaired patients. Furthermore, arthroscopic surgical stabilization offers better shoulder mobility, satisfaction, and quicker return to activity time. Surgical repair is an appealing option for high-risk patients who have experienced traumatic anterior shoulder dislocation, are between the ages of 21-30 years, and who participate in high-risk sports. […] Achieving the best long-term results when managing primary anterior shoulder dislocations requires a systematic series of decisions. First, the proper diagnosis must be made, as well as detection of any comorbidities.

• #120 DISLOCATED SHOULDER | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/shoulder-dislocations

  The most common problem is recurrence of the dislocation because the tendons within the joint might have been torn. Some patients can experience recurrence simply by being bumped while hanging onto a handrail during a bus ride or just sleeping with their arm on their forehead. Once a shoulder has been dislocated, surgery may be necessary to repair the torn ligaments to prevent frequent recurrent episodes. […] Other than the bruised or torn tendons within the joint, other pathological manifestation of shoulder dislocation includes tears to the surrounding tissues, cracked in the front bone socket, or torn ligaments around the shoulder. This is why arthroscopic shoulder surgery plays a big role in evaluating the extent of injury in full HD as well as allowing repair sutures. […] If left untreated, dislocated shoulder can cause more damages to the head of the bone, the bone socket, and surrounding tissues.

• #121 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  Impression fractures of the humeral head (Hill-Sachs lesions) can be observed in up to 93 % of first-time cases of shoulder dislocation. […] The extent of the bone loss on the glenoid must be seen in conjunction with the size and location of the Hill-Sachs lesion. Computed tomography (CT) with three-dimensional imaging is an important aid for identifying and evaluating bone damage in the shoulder, particularly in patients with recurrent dislocations. […] Young people (30 years) and active patients should be considered for surgery as the risk of recurrent dislocations is high. Surgical stabilisation at an early stage can prevent further damage to shoulder stabilising structures. […] A wait-and-see approach and repeated episodes of instability can cause further injury to the stabilising structures, including increased bone loss. The loss of function in cases of repeated episodes of instability is not well documented, but the aforementioned meta-analysis indicated that young patients and individuals who rely heavily on their shoulders to perform can benefit from surgical stabilisation after first-time shoulder dislocation, particularly where bone loss has been established and a high function level is needed, such as in contact sports.

• #122 Dislocated Shoulder: Causes and Treatment | The Hand Society

  https://www.assh.org/handcare/condition/dislocated-shoulder

  The shoulder is unique because the stability does not come from the shape of the bones, like the hip joint, for example. Most of the stability of the shoulder comes from the soft tissues that surround the ball and socket. […] When an injury happens, these ligaments and the labrum can be damaged, and a shoulder dislocation can result. […] If a large enough force in the right direction is applied to the arm, the ball will dislocate from the socket, resulting in a dislocated shoulder. […] The decision to have surgery often comes down to the risk for re-dislocation and any other associated injuries. Repeated shoulder dislocations can lead to cartilage damage and bone loss, which in turn can lead to pain, weakness, chronic instability and osteoarthritis. […] The main goal of stabilization surgery after suffering a dislocated shoulder is to keep the shoulder in place while keeping as much range of motion as possible. This is usually done by repairing the structures that were damaged during the dislocation. […] One commonly used name for this injury is a Bankart tear. This is named after Dr. Arthur Bankart, the physician that first described it in 1923.

• #123 DISLOCATED SHOULDER | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/shoulder-dislocations

  The most common problem is recurrence of the dislocation because the tendons within the joint might have been torn. Some patients can experience recurrence simply by being bumped while hanging onto a handrail during a bus ride or just sleeping with their arm on their forehead. Once a shoulder has been dislocated, surgery may be necessary to repair the torn ligaments to prevent frequent recurrent episodes. […] Other than the bruised or torn tendons within the joint, other pathological manifestation of shoulder dislocation includes tears to the surrounding tissues, cracked in the front bone socket, or torn ligaments around the shoulder. This is why arthroscopic shoulder surgery plays a big role in evaluating the extent of injury in full HD as well as allowing repair sutures. […] If left untreated, dislocated shoulder can cause more damages to the head of the bone, the bone socket, and surrounding tissues.

• #124 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  Management strategies for dislocations often include surgical options. For patients under 30, non-surgical treatment has been associated with significantly higher rates of recurrent dislocation outside of young adolescents. One study, over 10 years, determined that conservatively managed patients exhibited a 62% recurrence rate compared with 9% in surgically repaired patients. Furthermore, arthroscopic surgical stabilization offers better shoulder mobility, satisfaction, and quicker return to activity time. Surgical repair is an appealing option for high-risk patients who have experienced traumatic anterior shoulder dislocation, are between the ages of 21-30 years, and who participate in high-risk sports. […] Achieving the best long-term results when managing primary anterior shoulder dislocations requires a systematic series of decisions. First, the proper diagnosis must be made, as well as detection of any comorbidities.

• #125 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  Impression fractures of the humeral head (Hill-Sachs lesions) can be observed in up to 93 % of first-time cases of shoulder dislocation. […] The extent of the bone loss on the glenoid must be seen in conjunction with the size and location of the Hill-Sachs lesion. Computed tomography (CT) with three-dimensional imaging is an important aid for identifying and evaluating bone damage in the shoulder, particularly in patients with recurrent dislocations. […] Young people (30 years) and active patients should be considered for surgery as the risk of recurrent dislocations is high. Surgical stabilisation at an early stage can prevent further damage to shoulder stabilising structures. […] A wait-and-see approach and repeated episodes of instability can cause further injury to the stabilising structures, including increased bone loss. The loss of function in cases of repeated episodes of instability is not well documented, but the aforementioned meta-analysis indicated that young patients and individuals who rely heavily on their shoulders to perform can benefit from surgical stabilisation after first-time shoulder dislocation, particularly where bone loss has been established and a high function level is needed, such as in contact sports.

• #126 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  Management strategies for dislocations often include surgical options. For patients under 30, non-surgical treatment has been associated with significantly higher rates of recurrent dislocation outside of young adolescents. One study, over 10 years, determined that conservatively managed patients exhibited a 62% recurrence rate compared with 9% in surgically repaired patients. Furthermore, arthroscopic surgical stabilization offers better shoulder mobility, satisfaction, and quicker return to activity time. Surgical repair is an appealing option for high-risk patients who have experienced traumatic anterior shoulder dislocation, are between the ages of 21-30 years, and who participate in high-risk sports. […] Achieving the best long-term results when managing primary anterior shoulder dislocations requires a systematic series of decisions. First, the proper diagnosis must be made, as well as detection of any comorbidities.

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