Instability of the shoulder joint, habitual dislocation of the shoulder

Symptoms of dislocation

Depending on the type of injury, be it, for example, a dislocated hip, a dislocated leg, or a dislocated shoulder, the manifestations of the disease may differ from each other. So, with a similar problem with the hip joint, received at birth, the gait is often disturbed, the posture is bent, and one leg may even become shorter than the other.

However, there are still general symptoms of dislocation, based on which one can assume a dislocation of a certain part of the body:

• redness of the skin in the affected area;
• intense pain that intensifies when moving the dislocated limb;
• external change in the shape of the joint, an increase in its size;
• increased swelling in the injured area;
• loss of sensation in the limbs (this symptom is possible due to injury to nerve endings);
• difficulty in motor activity;
• increase in body temperature, high fever, chills.

Sprains

Sprains occur in a person if he performs sudden movements with a force exceeding the permissible load on the joint. When a ligament is sprained, there is partial damage or incomplete rupture of the capsule of the ligaments that strengthen the joint.

The ligaments most often affected by sprains are the ankle ligaments (especially when the foot rolls in) and the wrist joint. Somewhat less commonly, this injury affects the ligaments of the knee joint. When wearing high-heeled shoes, a woman often gets her legs turned inward and the Achilles tendon stretched.

Degrees of sprain

The following degrees of ligament damage can be distinguished:

• 1st degree , preservation of the mechanical integrity of the ligament with rupture of individual fibers. The presence of slight edema without hemorrhage is characteristic. The patient may feel moderate pain, with limited movement and support;
• Grade 2 , accompanied by partial damage to the articular capsule of the ligaments, the appearance of multiple fiber ruptures, frequent blood loss and moderate swelling. Difficulty in support, movements are quite painful and limited. Some instability of the joint is revealed.
• Grade 3 , complete rupture of the ligaments, which is marked by severe pain, significant swelling and bruising. When moving, joint instability is felt.

For grade 1 and 2 sprains, conservative treatment may often be sufficient.

For complete ligament ruptures, surgical treatment is used.

Causes

The main cause of dislocation, whether it is a dislocation of the shoulder joint or jaw, is indirect trauma. So, for example, if a person accidentally falls directly on his hand, stretching it forward, then, most likely, it is not the hand itself that will suffer, but his shoulder joint.

Often, damage occurs along with a number of severe bone diseases, as additional complications. These include:

• tuberculosis;
• arthritis;
• osteomyelitis;
• arthrosis and others.

Ligament tears

Ligament rupture is a fairly common type of injury for people whose work involves prolonged physical activity. Most often, ligament rupture accompanies a dislocation or fracture, but it can also be an independent injury.

In accordance with the reasons that caused the injuries, traumatic and degenerative ligament ruptures are distinguished. If the first type of damage can be obtained as a result of injuries, then the second occurs during the aging process of the body.

Symptoms of ligament rupture:

• pain and limitation of joint function (impossibility to straighten and lift the injured arm or leg);
• the appearance of edema, hematoma;
• change in the external contours of the damaged joint (joint instability);
• the occurrence of numbness and tingling in the affected limb.

A special place is occupied by ligament ruptures such as meniscus damage.

When should you see a doctor?

If you suspect you have a dislocated hip or dislocated hip joint, you should immediately seek qualified medical help. Otherwise, there is a risk of aggravating the condition of an already damaged joint.

It is necessary to provide first aid for a dislocation. The joint should be immediately immobilized and a cooling compress applied to it to reduce swelling. If the injured person feels unbearable pain, it is necessary to give him an anesthetic drug. Then you need to transport the victim to the hospital to provide him with proper medical care by an experienced trauma surgeon.

Specialists with many years of qualifications and enormous work experience are ready to accept patients at JSC “Medicine” (clinic of Academician Roitberg) at any time. The multifunctional medical institution is located in the center of Moscow, at 2nd Tverskoy-Yamskaya Lane, 10, close to the Mayakovskaya, Belorusskaya, Tverskaya, Novoslobodskaya and Chekhovskaya metro stations.

Diagnostics

Diagnostics

• examines the joint;
• pays attention to its configuration, the presence of an inflammatory reaction (redness of the skin, swelling of soft tissues);
• determines the possibility of performing active and passive movements, as well as their volume.
• if necessary, prescribe an additional objective study, which makes it possible to determine the nature and severity of possible damage to the joint structures.

For objective diagnosis, visualization methods are used, which include radiography (the study is carried out in frontal and lateral projection), computed or magnetic resonance imaging, which is a layer-by-layer scanning of tissues with high separation power, as well as ultrasound.

In modern medical clinics, diagnostic arthroscopy is performed to examine internal structures, which is their visualization using a small tube inserted with a camera and lighting. It can be used as a curative operation (habitual shoulder dislocation). Diagnostic prices depend on its volume and the methods used.

Treatment of injury

It includes mandatory repositioning of the displaced joint and returning it to its previous position. The manipulation can be performed under both general and local anesthesia. Finally, a plaster cast is applied to the damaged area.

In addition, there is often a need for additional procedures:

• therapeutic massage;
• recreational gymnastics;
• acupuncture sessions.

In particularly difficult situations, surgery may be indicated. If the cause of the dislocation is a bone disease, you should definitely give it due attention and carefully treat it, otherwise the injuries will recur again and again.

operations

operations

These types of surgical intervention can be performed using arthroscopy or open access. The choice of technique is determined by the doctor based on objective research data, as well as the technical capabilities of the medical clinic.

Arthroscopic operations

In modern medical clinics, whenever possible, arthroscopy is used, which makes it possible to correct habitual shoulder dislocations using small incisions. The cost of the operation and the overall course of treatment is lower, since the duration of the postoperative and rehabilitation period is noticeably reduced.

Arthroscopy is the method of choice, with which it is possible to effectively treat habitual shoulder dislocation. Video on the monitor allows the doctor to visually monitor the manipulations performed using special micro-instruments.

Open access operations

In case of significant violation of the anatomical integrity, leading to instability of the joint, plastic surgical interventions are performed using an open approach. To do this, wide incisions are made in the skin, subcutaneous tissue and capsule, allowing wide access to the structures being restored.

This type of surgical intervention can be used if it is necessary to perform osteoplastic surgery with implantation.

When surgical intervention is performed using an open approach to restore stability in such a pathological condition as a habitual dislocation of the shoulder, the prices are higher. This is due to the peculiarities of the operation, the need for a longer preoperative and rehabilitation period, and the frequent use of a significant number of drugs of various pharmacological groups.

Rehabilitation after injury

After the dislocation has been treated at the proper level and the patient has gone home with the doctor’s recommendations, the recovery period begins.

In order to strengthen muscles and bones and quickly return them to their previous condition, it is recommended:

• take a course of restorative massage;
• physical therapy course;
• take up regular swimming;
• do not avoid long walks in the fresh air;
• balance your own diet by consuming enough proteins, fats and carbohydrates required by the body.

Prevention of dislocation of the shoulder joint, jaw or other part of the body consists, first of all, of taking good care of your own health, proper nutrition and regular exercise.

Kinds

In modern medicine, there are several types of this pathological condition. These include:

• Primary recurrent dislocation, often resulting from congenital ligament weakness. It usually occurs when exposed to minor functional loads.
• Secondary release of the humeral head is the result of significant traumatic damage to the joint structures, leading to its instability, as well as improper treatment of the dislocation.

Based on the frequency of development of the pathology and the strength of the mechanical impact required to remove the head of the humerus, compensated, subcompensated and decompensated habitual dislocation of the shoulder is distinguished. Surgery or conservative therapy is prescribed by a doctor after an objective diagnosis with determination of the type of pathological condition.

What is an ankle sprain?

When the ankle joint becomes dislocated because ligaments are torn, it is called a sprained ankle. There are cases when the displacement of the joint and rupture of the ligaments did not occur completely. This is called a subluxation. This type of dislocation is not common. People at risk include older people with fragile bones. In addition, athletes or women who love high heels are more likely to get such a dislocation.

Medical practice distinguishes some types of ankle sprains:

• Not complete or partial ligament rupture. In most cases, the peroneus anterior muscle is injured. The deltoid, calcaneofibular and tibiofibular muscles may also be affected.
• The ankle muscles were severely torn. This dislocation is characterized by the absence of immobility of the limb, but the formation of swelling is observed. If you feel the damaged area, the person will experience pain. Typically, blood will accumulate in the injured area.
• The ligaments were completely torn. In this condition, a person experiences severe swelling and pain. He simply cannot step on his foot. In addition, it is clear that blood has accumulated inside.

If we talk about the reasons for a sprained ankle, this includes landing carelessly on the foot or carelessly turning. Dislocation can also occur due to a fall or blow. It is necessary to highlight some factors that contribute to the occurrence of such injuries:

1. presence of a high arch of the foot.

2. presence of weak ligaments.

3. if the peroneal muscles are underdeveloped.

4. minor sprain.

5. neuromuscular disorders.

6. impaired walking. If you place your foot incorrectly, the muscles will weaken over time, increasing the risk of joint dislocation.

In addition, there are certain diseases that cause weak ligaments, which increases the load on the legs. This happens with: obesity, cancer, tuberculosis, osteomyelitis, arthrosis, muscle paresis, congenital pathology.

Orthopedics and traumatology services at CELT

The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7

All services

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

First aid for acromial dislocation

When providing first aid to a victim who has suffered a dislocation of the collarbone, first of all, one should ensure fixation and calmness of the injured limb. This can be done using a bandage or a rag scarf. The arm is suspended in a bent state, and a small soft cushion is placed in the armpit.

Since the injury is very painful, it is permissible to apply a cold compress to the painful area. Ice should be wrapped in cloth to prevent the skin from freezing. This kind of compress can be applied for no more than a quarter of an hour with an interval of thirty minutes between procedures.

It is important to know!

Attempting to straighten a dislocation on your own is strictly prohibited, since inexperienced actions can lead to negative consequences. Also, until the ambulance arrives, you should not give the patient strong painkillers, which can change the clinical picture.

Treatment methods for habitual shoulder dislocation

As a rule, the patient consults a doctor after a long series of dislocations. Often the symptoms are erased or not noticeable. If a person has already undergone treatment, then a complete medical history can be reconstructed from his existing medical record.

Usually the specialist immediately notices:

• muscle atrophy while maintaining the shape of the joint,
• decreased sensitivity,
• restriction in movement due to fear of recurrent pain,
• caution in using your hand.

Only an experienced traumatologist can diagnose the presence of a habitual dislocation. He will examine the patient, collect anamnesis, and conduct the necessary instrumental studies.

To establish the presence of this type of injury, there are usually four main symptoms:

• Weinstein (limited movement in the forearm);
• Babich (muscles are in spasm, which makes passive movements difficult);
• Khitrova (if you pull the upper limb down, a gap appears between the bone and the articular process of the scapula);
• Stepanova (in the lying position the patient is not able to reach the couch on which he lies).

Additional diagnostic methods include radiography, ultrasound, arthroscopy, electromyography, etc. Good results can be achieved using magnetic resonance and computed tomography. They give a clear picture of all the features of bones, muscles, ligaments, as well as the tissues surrounding them. If necessary, arthrography is performed using contrast. It makes it clear which places are most affected as a result of habitual dislocation.

In the presence of this type of injury, therapeutic treatment is usually not effective, so in most cases surgery is recommended.

If the dislocation occurs a small number of times (no more than two), then it is necessary to wear a fixing bandage. To strengthen the joint, massage and therapeutic exercises are performed. The patient is also prescribed analgesics, external anti-inflammatory drugs, diuretics, wound healing agents, chondroprotectors, calcium supplements, etc.