Shoulder

Chronic Shoulder Dislocation

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Chronic Shoulder Dislocation

  • See Also
  1. Shoulder Dislocation
  • Definitions
  1. Chronic Shoulder Dislocation
    1. At least 3 weeks of a persistently dislocated Shoulder joint
  • Epidemiology
  1. Prevalence: 0.1 to 0.18% (rare)
  • Risk Factors
  1. Advanced age
  2. Degenerative Joint Disease
  3. Alcoholism
  4. Seizure Disorder
  5. Repetitive Trauma
  6. Chronic Rotator Cuff Tear
  • Findings
  1. See Shoulder Dislocation
  2. Shoulder Pain
  3. Severely limited Shoulder Range of Motion
  • Imaging
  1. Shoulder XRay
  2. CT Shoulder
  • Associated Conditions
  1. See Shoulder Dislocation for complications
  2. Bankart Lesion
  3. Hill-Sacks Lesion
  4. Acromion Fracture
  5. Proximal Humerus Fracture or Glenoid Fracture
  • Complications
  1. Rotator Cuff Atrophy
  2. Fibrous Capsular Contracture
  3. Frozen Shoulder
  4. Axillary Artery Injury
    1. Risk during chronic Shoulder reduction
  • Management
  1. Do not attempt closed reduction of a Chronic Shoulder Dislocation present for >3 weeks
    1. Prolonged dislocations form adhesions between Humerus and axillary artery
    2. Risk of axillary artery rupture on relocation maneuvers
    3. Relocation should be by orthopedic surgery typically in the operating room
  2. Refer to orthopedic surgery
    1. Open reduction
    2. Various other procedures have been performed (arthroplasty, hemiarthroplasty, Latarjet, Bankart repair)
  • References
  1. Herbert and Webley in Herbert (2015) EM:RAP 15(3): 1
  2. Kiel (2022) Crit Dec Emerg Med 36(12): 18-9
  3. Verhaegen (2012) Acta Orthop Belg 78(3): 291-5 [PubMed]
  4. Sahajpal (2008) J Am Acad Orthop Surg 16(7): 385-98 [PubMed]