Shoulder Dislocations /Shoulder Instability
The shoulder joint is stabilized by the shoulder labrum and capsule. The labrum is a cartilage-like ring surrounding the glenoid The capsule is a series of ligaments that connects the humerus to the glenoid. When the labrum and/or ligaments stretch or tear, the shoulder has a greater tendency to dislocate. This is known as instability, which can lead to greater and more painful shoulder conditions, especially dislocation and subluxation.
Immobilization of arm after first dislocation
The usual period of immobilization is about 3 to 4 weeks in young patients.In old age sling is enough. Earlier the immobilization was very rigidly followed for fear of recurrent dislocation. However, studies have shown that the possibility of recurrence is dependent on the age of the patient and not on the period of immobilization. In the age group 20-40 years the possibility of recurrent dislocation is about 60%.
Head (ball) of the joint repeatedly comes out of joint at some particular movements of the shoulder eg. on ladder, when swimming, during traveling in the bus in standing.Patient need surgery to stabilize the shoulder joint ( arthroscopic bankart's repair)
Special X rays and MRI with the contrast needed most of the time to confirm the diagnosis.
A contrast MRI is performed by injecting a fluid called gadolinium into the shoulder; the gadolinium helps to differentiate tears of normal structures, including SLAP tears.
Surgery for shoulder recurrent shoulder dislocation
The new technique is arthroscopic shoulder stabilization using suture anchors(Arthroscopc bankart repair). This is done with either metallic or biodegradable suture anchors.
The operation involves reattachment and tightening of the torn labrum and ligaments of the shoulder (see pictures below). This is done with either metallic or biodegradable suture anchors with the help of arthroscopy.