How to recognize the habitual dislocation of the shoulder? Causes, diagnosis, surgical and conservative treatment

By habitual dislocation of the shoulder is meant a pathology characterized by chronic instability in the joint.

The essence of the disease reflects the inconsistency of the fixing apparatus of the joint, which leads to frequent and permanent dislocations, manifested either in the performance of physical work, and sometimes during sleep. At the same time, if there is such a dislocation of the shoulder - first aid is either on its own or in the receiving room. After this, it is worth considering the possibility of surgical intervention.

Characteristic of the habitual dislocation of the shoulder

The cause of the development of the disease is the primary dislocation of the shoulder, accompanied by damage to the cartilaginous lip of the articular surface of the scapula. This structure is a place of contact with the head of the humerus, as well as a limiter of its mobility from above and below.

The most frequent exfoliation of cartilage is observed in the lower segment of the articular process of the scapula, which is observed with anterior or lower dislocation of the shoulder. Symptoms of habitual dislocation in the shoulder joint are the same signs that are characteristic of the primary dislocation except for the pain syndrome. Patients, as a rule, do not feel pain, but note the appearance of functional defects, as well as the symptomatology of compression of the nerves.

A habitual dislocation of the shoulder is a permanent pathology that will manifest until a surgical intervention is made to fix the cartilaginous lip to the scapula. The essence of the intervention is the fixation with the help of metal anchors, having a different shape of the tip resembling the shape of the anchors.

This operation is performed endoscopically. At the same time, for such a pathology as the habitual dislocation of the shoulder, treatment based on this technique is the gold standard, that is, the most optimal way of correcting the disorder.

Effective method of treatment

The only effective way to treat such a pathology as a habitual dislocation of the shoulder is surgery. The cost of this intervention depends on the specific medical center and is not fixed, since the entire treatment package also includes a rehabilitation period, the costs of which the paid clinics have to bear the costs for patients.

In public hospitals and medical trauma centers, this operation is performed free of charge, which does not incur significant losses due to relatively inexpensive consumables, as well as the necessary equipment. Therefore, this type of treatment should be recommended to all patients suffering from pathology.

Surgery is especially appropriate in the period of 6 months from the moment of rehabilitation after a repeated dislocation. Recovery after a shoulder dislocation, operated according to the Bankart method, takes about 3-4 weeks, after which the patient can perform more difficult manipulations with the help of a damaged upper limb.

Operation of Bankart as a method of treatment of

The arthroscopic operation of Bankart is the most modern method among effective methods, which allows to correct the dislocation of the shoulder. Treatment with the help of this technique is aimed at fixing the cartilaginous lip, as well as creating a pathological mobility of the head of the humerus of the bead from the connective tissue capsule of the joint.

At the same time, operative access is carried out by means of two incisions with a section of 1-2 cm. Through them, manipulators and an arthroscope are introduced into the joint cavity, allowing to visually monitor the condition of the tissues, and also to fix the joint elements.

Features of performing physical exercises

Physical work or exercises in such a pathology as the habitual dislocation of the shoulder can not be performed in full, as it was possible before the primary dislocation. After it, there are repeated dislocations, and this is often not related to the failure of correction or the vastness of the traumatic defect. Therefore, during rehabilitation after dislocation of the shoulder, physical work, as well as early training with weights can not be performed. Those exercises that are aimed at strengthening the muscular apparatus, namely the deltoid muscle, also should not be practiced early. This is due to the fact that the muscle inserts in the fixing capacity very little, because the main role is played by the joint capsule, which is damaged in the course of the dislocation, and also the ligamentous apparatus.

After primary dislocation, LFK has the desired therapeutic effect, although it is impossible to completely eliminate the possibility of developing a habitual shoulder dislocation, the operation in which is the most optimal way of correcting the pathology, can not. In this case, exercise therapy after dislocation of the shoulder is aimed at expanding the range of muscle contraction, the functional activity of which is partially reduced by the rehabilitation period, when the limb was fixed with a plaster bandage.

Also exercises after a shoulder dislocation are designed to reduce the chance of incorrect fusion of damaged structures of the fixing apparatus of the shoulder joint. The joint capsule, as well as the cartilaginous lip that has peeled off in a certain area, without the functional activity of the shoulder, can grow together with the formation of defects that reduce the range of motion.