Shoulder dislocation and instability

What is a shoulder dislocation and how often does it occur?

Shoulder dislocation is when the head of the humerus comes out of the socket where it normally sits on the scapula. If the protrusion is complete it is a dislocation, and if the protrusion is partial it is a subluxation. Both are the two forms of instability of the shoulder joint. The shoulder joint is the most mobile joint in the human body and also the most unstable, which is why dislocation is a very common pathology in this joint.

What happens in a shoulder instability?

When the head of the humerus leaves the place where it was lodged in the scapula, that is an instability so much of total form in a dislocation as of partial form in a subluxation, a series of injuries take place in its interior. If the injuries are severe, the ligaments and articular meniscus will be torn from the scapula socket and if healing does not occur, instability of the shoulder may persist. In other words: the head of the humerus can dislocate repeatedly and the patient then has a recurrent dislocation, that is to say, a shoulder that keeps coming out of place on several occasions.

Are all instabilities the same?

There are two main types of instability, atraumatic instability, that is, without trauma or due to minimal trauma, which is due to lax ligaments. They are often reversible injuries that do not require surgical treatment. The second major type of shoulder instability is traumatic instability, i.e. due to major trauma, for example a sports accident. In this type of instability the lesions are of greater magnitude and often require surgical treatment, especially in young patients in whom the lesions are of greater consideration.

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What does the treatment consist of?

The treatment of shoulder instability will vary according to each type of instability and must be adapted to each type of patient. In atraumatic instability the treatment is conservative, with good results in most cases, performing an exercise program to strengthen the muscles. In the second type of instability, traumatic instability, the treatment in most cases will be surgical and currently arthroscopic in more than 90% of cases. Shoulder arthroscopy, through small incisions, placing a television camera and instruments to operate inside the joint, makes it possible to correct existing injuries. Shoulder arthroscopy is currently a very safe technique that allows correction of instability with a very comfortable postoperative period and little discomfort for the patient.