Dislocation of the shoulder( shoulder joint of the hand) - Causes, symptoms and treatment. MF.
In the "people" it is customary to call any dislocation of ligaments a dislocation, due to the twisting of the limb. However, dislocation of is considered the displacement of the articular surface of one bone relative to the other, the displaced articular part of the bone( in this case the head of the shoulder) is out of the joint and can simultaneously damage the nerves and vessels passing next to it.
Symptoms of dislocation of the shoulder
Of all the joints of the human body, it is the shoulder joint that is most often dislocated. The dislocation of the shoulder is one of severe injuries and is fraught with the development of complications. The most common complications after dislocation are: contracture( restriction of movements) of the shoulder joint, nerve damage and hand paralysis.
The main symptoms for shoulder dislocation are:
• The pain of the in the shoulder joint, which is strong enough and accompanied by a feeling of severe discomfort in the joint.
• Visible deformation of the
• Movement limitation in the shoulder joint. Active movements are severely limited, when you try to take your hand with outside help, there is a "spring resistance" symptom.
• swelling with shoulder dislocation can spread to the
brush • If the nerve is damaged, can be paralysis of the hand or hand in general , as well as skin sensitivity disorders.
With repeated( habitual) dislocations of the shoulder, all symptoms can be expressed to a lesser extent. The habitual dislocation of the shoulder can spontaneously recur and repeat at a frequency of several times a month or more, delivering a lot of indignation.
First aid for dislocated shoulder
The shoulder joint must be immobilized, this is achieved by hanging a hand on the kerchief. You can not try to independently adjust the dislocation, as well as engage in diagnosis and ask the patient to move his hand. With a pronounced pain syndrome, you can give anesthetizing, but remember that swallowing the tablets with liquid, you will delay the time of giving anesthesia to correct the dislocation.
Diagnosis of shoulder dislocation
For diagnosis, radiography is used, which is prescribed before and after the adjustment of the dislocation, to control the standing of bones in the joint. To determine the presence of ruptures in the capsule and muscles of the shoulder joint, ultrasound or MRI is performed. In case of nerve damage, electromyography is used.
Snapshot of shoulder joint dislocation
Treatment of dislocation of shoulder
Treatment begins with the alignment of the dislocation under general anesthesia. It is possible to direct the dislocation under local anesthesia with the usual dislocations of the shoulder and in the elderly. After repositioning, a gypsum or its replacement bandage is applied, immobilizing the shoulder joint for a period of 3-4 weeks. With old and stale dislocations, the direction can be associated with difficulties, in this case, the dislocation is eliminated by the operative method, simultaneously sewing the capsular-ligament apparatus of the shoulder.
Gypsum with dislocated shoulder
With the usual dislocations, the operation on the plastic capsule and ligaments of the shoulder joint is done in a planned order, after the operation the joint is immobilized with a plaster bandage or a special discharge line.
Dislocation of the shoulder joint can be accompanied by damage and rupture of the rotator cuff of the shoulder joint, which also often requires surgical treatment and stitching and plasticity of the muscles surrounding the shoulder joint.
Rehabilitation after dislocation of the shoulder joint
From the first days after the adjustment of the dislocation proceed to active movements in the healthy arm and fingers of the sore arm.
From 7-10 days, it is possible to perform isometric contractions of the muscles under the plaster bandage. Also, physiotherapy can be prescribed in these terms: magnetotherapy( for the purpose of relieving pain and inflammation), UFO for a healthy shoulder joint( in this case, there is a reflex action), the procedures are prescribed by a course of 8-10 sessions.
After the removal of gypsum, the spectrum of physiotherapy procedures expands, ultrasound is prescribed, including hydrocortisone, magnetotherapy, laser therapy, electrophoresis, etc. All physiotherapy procedures are aimed at reducing pain and inflammation, and improving tissue nutrition, which speeds up the rapid development of movements and promotesrecovery.
To develop the movements in the shoulder joint proceed after the removal of gypsum, the exercises are done for 10-15 repetitions, 3-4 times a day. Exercises can be duplicated in the pool or sea water.
Exemplary exercises for the development of movements in the shoulder joint:
• Position - standing, with hands down along the trunk. Both shoulders are raised and lowered with arms extended in the elbow joints.
• Position - too. Circular movements in the shoulder joints.
• Position - too. We reduce and divide the shoulder blades on the back.
• Position - the brushes are placed on the shoulder joints. We perform rotational movements in the shoulder joints.
• We try to close the brush in the lock on the back, changing them in turn.
• We connect the brushes to the "lock", palms forward. We try to raise our hands as high as possible.
• Position - too. We spread our hands to the sides.
If you have significant difficulties, you need to use the help of the second hand. And to develop the outgoing movements in the shoulder joint, you can by moving your fingers along the wall. With the increase of the pain syndrome, take a break and( or) apply anti-inflammatory ointments( fastum gel, ultafastin, etc.) and salt baths.
After a month or more after the injury, you can start a massage. In the massage zone, except for the shoulder joint, you can include the entire cervical-collar zone.
General terms of treatment of dislocation from 1.5 to 3 months.
Prognosis after dislocation of the shoulder
The prognosis is quite favorable, but can be quite serious if the nerves and muscles of the rotator cuff of the shoulder are damaged. Among the unpleasant consequences is the habitual dislocation of the shoulder, which occurs some time after the first dislocation and in the future, in the absence of the necessary treatment, can be repeated more and more often.
Physician-traumatologist Voronovich NA