What Is a Glenohumeral Dislocation?

Due to external forces or other reasons, the articular surface of each bone of the joint loses its normal mating relationship. Traumatic dislocation is caused by trauma; pathological dislocation is caused by joint disease; after dislocation, the joint surface completely loses the mating relationship is complete dislocation; partial loss is subluxation. Traumatic dislocation is more common and occurs in young adults. The joints most prone to dislocation are the elbow joint, followed by the shoulder and hip joints.

Joint dislocation

This entry lacks an overview map . Supplementing related content makes the entry more complete and can be upgraded quickly. Come on!

Due to external forces or other reasons, the articular surface of each bone of the joint loses its normal mating relationship. Traumatic dislocation is caused by trauma; pathological dislocation is caused by joint disease; after dislocation, the joint surface completely loses the mating relationship is complete dislocation; partial loss is subluxation. Traumatic dislocation is more common and occurs in young adults. The joints most prone to dislocation are the elbow joint, followed by the shoulder and hip joints.

nickname

Joint dislocation

English name

Dislocation

Common locations

Elbow and knee joints

Recurrent or habitual shoulder dislocation is mainly divided into two categories: one is that you can dislocate the shoulder joint, and then you can get back to the normal position, that is, the patient can "play freely in and out of his shoulder ; The second type is the most common, mainly due to trauma, that is, the dislocation of the shoulder joint caused by external forces

Patients of the first type of habitual shoulder dislocation have no history of significant trauma,

dislocation

Also, there may be excessive stretch and relaxation in multiple joints on the body. For example, the thumb can be easily folded back and touch the forearm; the main reason for the excessive extension of the elbow or knee joint is that the congenital body tissue is loose and the joint is unstable, and it is multidirectional. As for the second type, the habitual dislocation caused by injuries is mostly due to obvious trauma, such as

The first experience of dislocation of the shoulder joint due to injury was very profound. The reason was severe pain. I felt that my shoulder was dislodged and became stuck and unable to move. If you screw it up, it will make a rattling sound and feel severe pain. Most people need to use external force (western or Chinese medicine) again to "reset the shoulder joint", and a small number of people can "pull back" with the assistance of themselves or their companions. In short, after a bit of tossing, "the shoulder that fell off went back again, and after a few weeks of rest, the shoulder returned to normal function. But one day, the patient lifted the shoulder, turned out and The abduction action is simply a throw-like action, the shoulder joint falls out again, and becomes stuck and painful. It cannot get it back on its own, this is a recurrent dislocation; it may also be felt With a sound, the shoulder twisted and suddenly did not listen to the call, but you can turn it back on its own, which is a recurrent subluxation. The probability of recurrence of the dislocation is closely related to the age of the first dislocation. According to statistics, the first Shoulder dislocation due to trauma occurs twice. If it occurs in young people under 20 years of age, the chance of recurrence and dislocation will be 60% to 95%. If it occurs in people 20 to 30 years old, the chance of recurrence is 40% to 70%. %; When it occurs between the ages of 30 and 40, its recurrence rate is 10% to 40%; if it occurs in young people who like sports, the probability of recurrence can be as high as 80%. One for two, two for three ... . Once the recurrent dislocation begins After that, it will restrict the normal activities and movements of many shoulder joints. Not only can't engage in many sports and work, even if you are careful and pay attention, you will often accidentally dislocation or subluxation in daily activities, such as pulling heavy Clothes, putting on and taking off clothes, turning over to sleep, etc. The more the dislocations occur, the more easily the shoulder joint will become dislocated, and the more "self-resetting" will occur. Of course, the range of motion of the joint will be more limited.

The problem is the important structure that maintains stability in the shoulder joint (scapulohumeral ligament) during the first injury,

Joint dislocation

Local pain, swelling, dyskinesia, and deformity of the joint after the injury can be diagnosed accordingly. In order to determine the direction and extent of dislocation and whether a fracture is associated, an X-ray examination is necessary. Relocation should be performed in time for the dislocated person, the sooner the better. After resetting, the joint should be fixed in a stable position for 2 to 4 weeks; after the fixation is removed, active functional exercises should be performed to restore joint function. If manual reduction fails, surgical incision should be performed. Torn from the edge of the mesial glenoid due to dislocation of the joint and detached from the bone. Although the joint was reset, the injured part did not heal, forming a permanent gap, which could not maintain the stability of the shoulder joint. More than 90% of the dislocation of the shoulder joint is prolapsed from the front. Therefore, the peeling of the glenoid labrum ligament is also located in front of and below the scapula. In addition, the number of dislocations has increased, and the joint capsule in the front has become more and more relaxed, which also makes dislocation more likely to occur. Once dislocation, the joint will be injured once, which will not only cause the articular cartilage to wear or peel off. It can even cause tearing of the superior labral ligament. Most patients don't care about the instability of the shoulder joint "in and out of the palate," they believe that as long as more attention is paid to certain bad postures or certain activities, it can reduce dislocation. The chance of it happening; some people think that it only takes a long time to get out of it once and it does nt matter much; and some people think that they will reset themselves more and more. Has the condition eased? Recently, more and more research reports and our own experience show that the shoulder joint is often unstable and accumulated multiple dislocations or subluxations, which will cause the wear of the articular cartilage, and there is a great chance to obtain the shoulder joint. inflammation.

For the treatment of congenital habitual dislocation, because there is no obvious lesion, the problem lies in the relaxation of the tissue structure.

dislocation

Therefore, in principle, conservative (non-surgical) rehabilitation treatment is mainly used to train the muscles around the shoulder joints to strengthen the muscles to help stabilize the joints. The effect is about 80%. Unless it is necessary, the joint capsule is surgically tightened to reduce the range of joint movement to maintain stability. As for the treatment of traumatic shoulder dislocation, there are two aspects: in the acute phase, that is, when the first dislocation occurs, the conservative joint reduction was used to "wait for its changes", but for young people and The high recurrence rate (80% -95%) of sports-loving patients also makes us start to think about better treatments to reduce "well knowing that there will inevitably be a bad prognosis for radon. In recent years, due to the development of arthroscopic surgery, microtraumatic surgical techniques are used to target young people, athletes, sports-loving patients, or soldiers and policemen with special occupations after the first dislocation of the shoulder joint. The scapulohumeral ligament is stripped to reduce the chance of future recurrence and the problems it brings, and the complexity of retreatment after relapse. The results of arthroscopic surgery can reduce the chance of recurrence of these patients with high relapse rates to less than 10% -20%. On the other hand, conservative rehabilitation is not effective for habitual dislocation after trauma, with a success rate of less than 20%. However, if these lesions are corrected surgically, the torn ligaments are sutured and the loose joint capsule is tightened. After surgery, shoulder straps are used to protect two to four weeks, and passive joint activities are started. Muscle training begins in eight weeks and twelve weeks Resume daily activities and resume exercise for four to six months. We have calculated that the success rate of surgery in the past 10 years can reach 95%. In recent years, we have begun to use arthroscopy to treat patients. In addition to the aforementioned patients with the first shoulder dislocation in the acute phase, we also repair some patients with habitual dislocations whose lesions are not too serious. The advantages of arthroscopic surgery are small wounds (three small holes), less pain after surgery, easier rehabilitation, joints that are less prone to stiffness, and easy recovery of normal range of motion and function. The short-term treatment effect is similar to that of open surgery.

Do not neglect the importance of habitual dislocation of the shoulder joint. The diagnosis must be determined (history inquiry, physical examination and magnetic resonance imaging) before deciding on the treatment direction. Not caused by injury

Joint dislocation is a common emergency in sports injuries. Human joints are divided into immovable, partially movable and movable joints. Dislocation refers to the dislocation of bones from joints.

dislocation

Dislocations usually result in pulling or tearing of the ligaments, and in severe cases, fractures can occur. Clinical features include: joint protrusion and loss of function, joint deformation and pain, and moderate to severe swelling. If the dislocated bone compresses the nerves, the limbs below the dislocated joint will become numb; if the blood vessels are compressed, the joints below the dislocated joint will not feel the pulse and become purple. For any patients with fractures and dislocations, be sure to measure the pulse strength and check the sensory function. If you can't feel the pulse, it means that there is not enough blood supply to the limbs and you must go to the doctor immediately. At the same time, during the first aid, pulse and motor sensory functions should be measured both before and after fixation.

First, check the pulse: touch the pulse at a distance from the heart on the injured side, such as the elbow dislocation to check the radial artery, the shoulder dislocation to check the brachial artery, the ankle dislocation to check the dorsal foot artery, etc., and on the nail of the injured limb of the patient, Relax after applying pressure and measure the time it takes to return to normal color. The normal value should be less than two seconds. If you cannot feel the pulse or the nail color recovers slowly, it means that the injury is serious or the bandaging is too tight. You must relax. Second, check the distal motor and sensory functions: ask the patient to swing their upper and lower limbs by themselves and touch the patient's fingers or toes to see if they can be clearly identified. If the patient is unconscious, gently touch the patient to observe the pain response. The shoulder joint feels like a ball in a glove and is less stable. If it is hit, falls, cramps, throw the ball hard, etc., it is very likely to cause dislocation of the shoulder. In 96% of patients, the humeral head will be forced forward, and the dislocation of the shoulder joint will also be accompanied by fractures of the upper limbs, with ligament lacerations or vascular and nerve injuries. In addition to being unable to move, the patient sometimes faints due to severe pain. If there is only shoulder pain without any trauma, the cause of the patient must be evaluated first, such as the location of the pain, the feeling, and the injured side. Compared with healthy side motor function, debilitating condition and weakness.

First of all, in order to prevent the patient from falling again and injured, help him to sit down or lie down, check for other injuries, and check the distal pulse to make the patient quiet, warm and prevent shock. Usually, the sitting position is the most comfortable. Fixing the dislocated part is the best way to reduce pain. Self-rescue methods can use magazines, thick newspapers or cardboard to support the elbows. In addition, using a triangle towel to fix the elbows on the chest can avoid shoulder movement and reduce pain. It is forbidden to eat because general paralysis treatment may be needed. You can use chat to distract the patient to reduce their pain. In addition, use ice to reduce the patient's pain and swelling. If you want to move the patient, try to move her as much as possible. Automatically, he assists him by supporting his elbows and wrists. At the same time, he can use a small pillow or cushion to place it on the inside of the injured side of the patient and between the chest. If the patient can tolerate pain, it is very good to give immediate reduction. As far as the dislocation of the shoulder is concerned, it can be considered that the patient's elbow of the injured limb is held tightly with both hands at 90 degrees. a recovery.