In 2011, shoulder dislocations accounted for 175,641 emergency department visits in the U.S., although some patients choose to reset the joint without any medical assistance.
“We do not recommend self-setting of shoulder dislocations,” says Richelle Takemoto, MD, an orthopaedic surgeon with Kauai Medical Clinic/Wilcox Memorial Hospital. Dr. Takemoto and her co-authors recommend immediate medical attention for a dislocated shoulder that includes radiographic images before and after reduction (resetting of the shoulder) to check for related fractures and other musculoskeletal injuries.
The cause of injury, the presence of an associated fracture and/or nerve injury, and the difficulty in resetting the shoulder all contribute to a patient’s outcome.
“Acute shoulder dislocations can be effectively managed by closed reduction maneuvers,” says lead study author Thomas Youm, MD, clinical assistant professor, New York University Hospital for Joint Diseases. “There are a plethora of closed reduction techniques available for relocation of a dislocated shoulder. A thorough understanding of these reduction techniques as well as immobilization strategy and rehabilitation regimens can successfully treat dislocations of the shoulder and hopefully prevent the need for surgery.”
If you have dislocated your shoulder
- Promptly seek orthopaedic care—at latest, within one week from injury—to ensure the best diagnosis and treatment.
- Monitor for possible nerve damage pre- and post-reduction surgery.
- Once the ligaments have healed, appropriate counseling is needed to rehabilitate the injury and to prevent frozen shoulder. Among seniors, persistent weakness in the shoulder should be checked for a possible rotator cuff tear(s).
By the numbers
- Forty percent of shoulder dislocation patients have an associated structural (ligament or muscle) injury.
- One of three shoulder dislocation patients also has a rotator cuff tear.
- Males ages 10 to 20 have the highest rate of shoulder dislocation.
- Recurrent dislocations are most likely to occur within two years after an initial dislocation, most often in patients younger than 20.
- Six of 10 younger patients developed instability over two years and seven of 10 over five years following a dislocated shoulder.
- Men are more likely to have recurrent instability following a shoulder dislocation than women.
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More information about the AAOS
From the Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, N.Y. (Thomas Youm, MD, and Brian Kyu-Hong Park, MD) and the Bone and Joint Center at Kauai Medical Clinic, Wilcox Memorial Hospital, Lihue, Hawaii (Richelle Takemoto, MD).
Dr. Youm or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of and serves as a paid consultant to Arthrex. Neither of the following authors, nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Takemoto and Dr. Park.
J Am Acad Orthop Surg 2014; 22: 1-11 http://dx.doi.org/10.5435/JAAOS-22-12-761.
|Lauren Pearson Riley