Shoulder Dislocation

A shoulder dislocation occurs when the head of the upper arm bone (humerus) is displaced from its normal position in the shoulder socket (glenoid). In other words, the humeral head comes out of its proper place, causing instability in the shoulder joint. The shoulder is the most mobile joint in the body, and this mobility makes it particularly vulnerable to dislocations.

Shoulder dislocations usually result from a traumatic event and, if not treated properly, can become recurrent.

Why Does the Shoulder Dislocate?

Shoulder dislocations most commonly occur due to the following reasons:

Trauma: Falls, direct blows, sudden movements, or sports injuries (especially common in contact sports).
Congenital Laxity: Some individuals naturally have looser ligament structures, making the shoulder more prone to dislocation.
Recurrent Dislocations (Chronic Instability): Individuals who have previously dislocated their shoulder are at higher risk of re-injury.

Dislocations most often occur in the anterior (front) direction. Less commonly, they may occur posteriorly (backward) or inferiorly (downward).

What Are the Symptoms?

A shoulder dislocation typically presents with sudden and severe symptoms:

Sudden, intense shoulder pain
Inability to move the arm
Visible deformity or asymmetry of the shoulder
Numbness or tingling in the arm (due to nerve compression)
Noticeable displacement of the shoulder from its normal position

These symptoms persist until the dislocation is properly reduced.

How is the Diagnosis Made?

The diagnosis is made by an orthopedic specialist through clinical evaluation and imaging techniques:

Physical Examination: The shoulder’s shape, range of motion, and neurovascular status are assessed.
X-Ray: Used to determine whether the humeral head is dislocated and to check for fractures.
MRI (Magnetic Resonance Imaging): If recurrent instability occurs after a dislocation, MRI is used to evaluate labrum tears, ligament injuries, or other intra-articular damage.

Treatment Options

Treatment is planned based on whether the dislocation is a first-time or recurrent injury, as well as the patient’s age, sports activity level, and overall health status.

Treatment of Acute (First-Time) Shoulder Dislocation:

Reduction: The dislocated shoulder is carefully repositioned by an orthopedic specialist.
Immobilization: The shoulder is kept stable using a sling for a period of time (usually 2–3 weeks).
Physical Therapy: Implemented to restore range of motion and strengthen the shoulder muscles.

Treatment of Recurrent Shoulder Dislocations (Chronic Instability):

Surgical treatment is considered for recurrent dislocations. The most commonly used methods include:

Arthroscopic Bankart Repair: The labrum tear and capsule laxity are repaired using a minimally invasive technique. This method is especially preferred in young and active individuals.
Latarjet Procedure: Provides joint stability with bone support. Typically performed in patients with advanced instability or bone loss.

Postoperative rehabilitation is crucial and forms the foundation for successful outcomes.

What Happens if Left Untreated?
Untreated or inadequately treated shoulder dislocations can recur over time, leading to chronic shoulder instability. With each dislocation, joint structures sustain further damage, which may result in serious complications such as:

Persistent shoulder pain
Limited range of motion
Joint osteoarthritis
Muscle weakness