ROSEMONT, Ill.--Prompt and appropriate treatment of a dislocated shoulder--when the head of the upper arm bone (humerus) is completely knocked out of the shoulder socket (glenoid)--can minimize risk for future dislocations as well as the effects of related bone, muscle and nerve injuries, according to a literature review appearing in the December issue of the Journal of the American Academy of Orthopaedic Surgeons ( JAAOS ).
The shoulder has the greatest range of motion of any joint in the human body and is the most common site for a full or partial dislocation. Shoulder dislocations are classified as "traumatic" or "atraumatic." Up to 96 percent of dislocations are traumatic, occurring most often during contact sports or when someone falls onto an outstretched hand. Atraumatic dislocations--when the shoulder starts to slip part way out without trauma--can cause limited shoulder movement in multiple directions.
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:
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December 2014 Full JAAOS Table of Contents
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Disclosures: 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-22-12-001 .
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