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Archive for the 'discolations' Category

Shoulder Dislocation

Posted by Dr.Prahallad Panda on 7th October 2009

I was very much surprised by seeing a boy tolerating the pain of shoulder dislocation for some hours. Dislocation of shoulder is a very painful condition. The person who has experienced it will only be able to understand the plight of the patient. It usually occurs due to a fall hitting the shoulder directly or fall on a out stretched hand. Some have inherent weakness in the ligaments and capsule of the joint, and dislocate is frequently called a recurrent shoulder dislocation. Some develop weakness around the joint in some diseases like SLE or due to long term consumption of steroids. Sudden jerky movement of arm may dislocate it if one is prone for it.

It may be anterior or posterior type. Dislocation diagnosis is obvious from the clinical examination by observing the loss of convexity of shoulder joint. The axillary fold is also deformed. Some may fracture the humerus, the underlying bone along with the dislocation in a trauma. X-rays of the shoulder will prove the diagnosis.

The anterior shoulder can be reduced under a general anesthesia or under sedation. I prefer to do it under sedation, because calling the anesthetist and arranging operation theatre takes time in our set up. So, with a little discomfort the long waiting period can be cut short which in turn will cut short the plight of the patient. There are several methods to do it. I employ a method where the patient sleeps on his abdomen on a high table, hanging the limb down whose shoulder has been dislocated. A weight of about 10 kilograms is tied to the hand, and cares is taken so that the weight hangs freely and gives a continuous traction. Within a short time the contour of shoulder returns with a sound of reduction. And the patient is free of pain. He will express it with a relaxing moan. The shoulder will be immobilized at least for two weeks and some analgesic prescription will complete the treatment. Recurrent dislocation is treated by surgery.

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