Treatment of shoulder joint dislocation

What is shoulder joint dislocation?

"The shoulder dislocates," "It dislocates repeatedly," "It looks like it might dislocate." Shoulder dislocation is one of the most common dislocations among the joints throughout the body.

The shoulder joint is made up of the head of the humerus (the upper arm bone) and the socket of the scapula (the joint cavity). While it has a very wide range of motion, it has limited structural stability, making it prone to dislocation due to falls or sports injuries. More than 90% of dislocations are "anterior dislocations" where the humeral head slides forward.

During a dislocation, the cartilage (articular lips) on the rim of the socket may be damaged (bankart injury), and the humeral head may be crushed (hirsax injury). In older people, it may also involve a fracture of the humeral neck (proximal part of the humeral head). These injuries can cause a recurrence of dislocation.

In such cases, seek medical attention.

My shoulders are very painful and I can't move them.
The shape of my shoulders is different from usual, and it feels strange.
The outside of the shoulder is numb and the sensation is dull.
The shoulder that was dislocated once has dislocated again; it looks like it might dislocate again and I'm afraid.

Repeated dislocation and instability in the shoulder

After the initial dislocation, the condition in which it becomes loose even with small forces or everyday movements is called "repetitive shoulder joint dislocation." This is because the joint lips and ligaments damaged in the initial dislocation remain without being fully healed, causing the joint to become unstable. People in their 10s and 20s who have experienced the initial dislocation are said to have a higher rate of re-dislocation.

Even without injury, due to the inherent looseness of the joints, the shoulder may still be prone to dislocating or feeling unstable (shoulder joint instability).

Tests performed at our clinic

Examination and consultation: To check for changes in the shape of the shoulder and for any nerve symptoms.
X-ray (front view, Y view, axial view): To confirm the direction of the dislocation and whether there is a fracture
Detailed tests such as CT and MRI: If necessary, we will refer you to the collaborating medical institutions.

medical treatment

Repair: Return the dislocated joint to its original position. If necessary, perform pain-relieving treatment.

FixedAfter the repair, the joint is immobilized for 3 to 4 weeks to stabilize it. Depending on the injured area and the risk of re-dislocation, choose the direction of immobilization.

rehabilitationThe physical therapist will instruct you on strengthening the muscles around your shoulders and on exercises to improve stability. They will also teach you how to avoid movements that are prone to dislocation and instability. For those who play sports, they will support you in a gradual return to activity.

When surgery is necessaryIn cases where a dislocation occurs repeatedly, or in those who need surgery (such as repairing the articular lips) to prevent recurrence, we will refer them to a medical institution that performs the surgery.

Doctors who treat this disease

The surgery is performed by a plastic surgeon. Our hospital has a plastic surgery specialist from the Japanese Society of Plastic and Reconstructive Surgery on staff.

Frequently asked questions

Q. My shoulder has healed on its own. Is it okay to go see a doctor without seeing a doctor?

A. A dislocated shoulder does not “go away on its own”; rather, subsequent immobilization, management, and rehabilitation are essential. If the articular lips or other parts of the shoulder are injured during a dislocation, they can cause the shoulder to dislocate again. We recommend that you check the condition once.

Q. The outside of my shoulder is tingling.

A. When a dislocation occurs, the shoulder nerve (axillary nerve) may be compressed, causing the outside of the shoulder to become numb or sensory function to deteriorate. In most cases, this resolves naturally, but it can be confirmed during an examination.

Q. It comes off repeatedly. Is there any surgery option?

A. In those who have recurring dislocations, surgery may be necessary. The instability in those with a naturally loose joint is primarily treated through rehabilitation. We will discuss the appropriate treatment plan based on the condition.