The shoulder is the joint with the greatest range of motion in the body. Moreover, the socket bone (glenoid) is relatively shallow. There is a bumper of cartilage, called the labrum, that surrounds the rim of the socket. Still, the shoulder is the most common dislocated joint in the body.

A shoulder dislocation is the complete disruption of the shoulder joint where the humerus bone (“ball” of the ball and socket joint) comes all the way out of the socket. Shoulder subluxation is the partial disruption where the humerus comes out and in part of the way. When the shoulder dislocates, immediate medical attention is warranted to put the humerus back in place (reduction of dislocation).

The shoulder, most commonly, dislocates when the elbow is away from the body and arm rotates so that the humeral head rolls out of the front of the socket. Dislocations towards the back are much less common. In either case, the labrum is torn in the direction of the dislocation.

Patients, after a reduction of their shoulder dislocation, are placed in a sling or immobilizing device for a period of time, and then careful range of motion is started to prevent stiffness. Often physical therapy is incorporated to regain range of motion and re-build strength.

It is advised to avoid contact sports or other activities that involves significant rotation. If the dislocation does not cause any tears, then often the patient gradually returns to regular activities within several weeks. If the dislocation resulted in a tear, then arthroscopic shoulder repair is often warranted. If the patient repeatedly dislocates the shoulder, then arthroscopic shoulder repair is warranted.

The younger the person is when they dislocate for the first time, the more likely they are to dislocate again and again throughout their life. Someone in or around the age of 20 years old has, approximately, an 80% chance of re-dislocating recurrently.

BANKART TEAR/ LESION:

One very common result of an anterior (towards the front) dislocation is a Bankart Lesion. This is the avulsion of the Labrum (cartilage rim around the socket) at the front lower portion of the socket bone (glenoid).

This labral tissue is connected to an important group of ligaments called the Inferior Gleno Humeral Ligaments (IGHL). Therefore, these ligaments often tear along with the labrum. Recurrent dislocations very typically have a Bankart Lesion. Another method of tearing the IGHL, as a result of shoulder instability, would be off the other end of its attachment which is the humerus bone.

SUPERIOR GLENOID LABRUM LESIONS/ SLAP TEAR:

This may also occur as a result of Shoulder Dislocation/Instability.

DIAGNOSIS:

An MRI (Magnetic Resonance Imaging) is the study of choice to diagnosis a Bankart Lesion.

TREATMENT:

 

References:

http://www.ncbi.nlm.nih.gov/pubmed/10901314

http://www.ncbi.nlm.nih.gov/pubmed/8504617

http://www.ncbi.nlm.nih.gov/pubmed/6546118

Request an Appointment Now