Three rules for treating a dislocated shoulder. Habitual dislocation of the shoulder (Habitual dislocation of the humerus)

Shoulder dislocation - prolapse (dislocation) shoulder joint. The most common type is the anterior one, although there are posterior, superior, inferior and intrathoracic varieties. Despite the reversibility of the injury, it may be accompanied by damage to the ligaments, tendons, nerves and blood vessels.

Causes of shoulder dislocation

The shoulder joint is one of the most mobile, so shoulder dislocation is an extremely common injury. Dislocations can be congenital or acquired. Acquired dislocation often occurs during training and games - bench presses, pull-ups, ball hits, but the main causes of injury are:

force impact on the shoulder area;
falling on an outstretched hand;
twisting the arm with force.

The most dangerous thing about this injury, according to doctors, is that a small amount of force is enough to dislocate the shoulder. In some cases, the likelihood of injury increases many times over, for example, with habitual dislocation or joint diseases. IN adolescence the shoulder joint may be in a “loose” state due to physiological characteristics this period. In all these cases it is necessary to avoid dangerous situations and prevent falls and other accidents.

Shoulder dislocation - symptoms

A dislocated shoulder causes such discomfort that it is impossible to ignore the injury, unlike, for example, some types of fractures with which people can walk for several days without seeking the help of a doctor. Main signs of a shoulder dislocation:

strong pain syndrome, in case of damage to nerves and blood vessels - tingling, numbness, bruising and swelling in the affected arm;
The shoulder joint looks and feels unnatural to the victim - it protrudes, falls, etc., often the injured person holds his hand like a baby.

First aid for a dislocated shoulder

Adequate emergency care for a shoulder dislocation injury is a guarantee of a successful recovery without complications. To an ordinary person you should not try to set the joint back in place yourself - this requires skills that only a traumatologist possesses, so the victim must be sent to the hospital. Before transporting, it is necessary to fix the arm so that the shoulder does not move. If possible, it is advisable to do cold compress. Immobilization for a shoulder dislocation (depending on the complexity) should last from 1 to 4 weeks, otherwise the dislocation may become habitual.

How to fix a dislocated shoulder?

Reduction of a shoulder dislocation is carried out by the most different ways– at one time, this problem was dealt with by Hippocrates, Meshkov, Dzhanelidze and other doctors who proposed their own methods. Before starting the procedure, anesthesia is required. For uncomplicated injury, inject into the affected area non-narcotic analgesic and novocaine or lidocaine. In case of complex trauma (with tissue damage and fractures), the patient is given general anesthesia before manipulation.

One of the less traumatic and most effective methods is the Kocher reduction of shoulder dislocation. With this method, the traumatologist performs a series of sequential actions:

takes the hand by the wrist and the lower third of the shoulder;
bends the arm at the elbow at a right angle;
pulls the hand along the axis of the shoulder and at the same time presses it to the body;
turns the hand so that the elbow is turned to the stomach;
turns the arm forward (elbow in front of the stomach);
turns again so that the elbow is near the stomach.

How to fix a dislocated shoulder yourself?

In emergency cases, the question may arise of how to straighten a dislocated shoulder yourself. If it is not possible to resort to qualified medical assistance, you can try the manipulation developed by Hippocrates. The patient should be laid on the couch on his back, the injured arm should be grabbed by the hand, and your leg should be rested against the victim’s armpit. Reduction of a dislocated shoulder occurs by simultaneously pulling the arm and pushing the head humerus heel into the joint. The correctness of the procedure is controlled by radiography.

Shoulder dislocation - treatment

Mild dislocations, not accompanied by fractures and damage to nerves, blood vessels, muscles and skin, require only a period of rest after the humerus has been established in its anatomical position. During this time, the joint capsule, muscles and ligaments return to normal, and after removing the plaster splint, the usual dislocation does not occur. The problem of how to treat a shoulder dislocation arises with complex, old and habitual dislocations.

To speed up the healing of damage, relieve swelling and restore joint mobility due to shoulder dislocation during immobilization and after it, the following procedures can be used:

therapeutic massage;
magnetic therapy;
infrared irradiation;
Microwave, UHF therapy;
medicinal electrophoresis;
paraffin applications.

Surgeries for shoulder dislocation

Surgical interventions for shoulder joint injuries are required when they occur. The Laterger operation for shoulder dislocations is prescribed when the bone that forms the edge of the glenoid cavity is worn away. This surgical intervention helps to avoid repeated injuries, and it consists in replenishing the missing bone mass.

Surgeries for shoulder dislocation are also necessary for:

inability to straighten the joint using a conservative method;
the need to form a normal joint capsule due to sprains and ruptures;
the appearance of inflamed, fibrous tissues, growths and other formations;
ruptures of ligaments, cartilage, tendons that need to be stitched.

Habitual shoulder dislocation - treatment without surgery

Treating a dislocated shoulder without surgery if the injury has become habitual is unrealistic. Ointments for a dislocated shoulder, as well as other drugs with local action (creams, gels), only reduce the severity of symptoms. To increase shoulder stability, strengthen ligaments and cartilage tissue The following medications are used:

Anti-inflammatory non-steroidal drugs (Diclofenac, Ketorolac, Ketoprofen, Indomethacin; Piroxicam).
Chondroprotectors(Dona, Teraflex, Alflutop, Artra, Chondrolon, Elbona).
Vitamin and mineral complexes(ArtriVit, Orthomol Artro plus, SustaNorm, Collagen Ultra).

How to treat a dislocated shoulder at home?

After the dislocation has been reduced in the hospital, treatment must continue at home. What to do if you dislocate your shoulder:

After applying a plaster splint, you should provide complete rest to your hand.
If there is inflammation or pain, take prescribed medications and go to physical therapy.
Strengthen bones and joints by taking vitamin-mineral complexes and chondroprotectors.
After removing the cast, carefully develop the arm and shoulder.

Shoulder dislocation - folk remedies

Numerous folk remedies for shoulder dislocations, they are effective as anti-inflammatory and pain relievers.

Helps with joint swelling alcohol compress. Gauze is moistened with vodka or alcohol diluted in half, applied to the joint and covered with compress paper and a towel. Keep the compress for 30 minutes.
To speed up joint healing ethnoscience recommends warm milk compresses. The gauze folded 4 times is moistened warm milk and apply to the shoulder joint, wrapping the compress on top with film and a towel. Change the compress after cooling, repeating the procedure for 30 minutes.

Decoction of wormwood (or tansy) for severe pain

Ingredients:

fresh wormwood (or tansy) leaves;
0.5 liters of water.

Preparation and consumption

Pour water over the raw material and boil for about 20 minutes.
Moisten the gauze with the cooled broth and apply a compress to the joint.
Wet the gauze as it warms. The duration of the procedure is 20-30 minutes.

Shoulder dislocation - consequences

the occurrence of habitual dislocation;
degenerative changes in the joint;
damage to peripheral nerves, which leads to decreased hand mobility and sensitivity disorders.

Exercises after a shoulder dislocation

A speedy recovery from a shoulder dislocation necessarily includes physical exercise, and the longer the immobilization lasts, the more important this stage of rehabilitation is. Exercises after a shoulder injury are aimed at increasing mobility. For the best effect, you need to start with the simplest exercises and a small number of repetitions. After strengthening the muscles, you can add repetitions and introduce load. At the first stage you can:

bend and straighten the elbow and fingers of the injured hand;
make rotational movements with small amplitude, move your arm to the side;
raise the sore arm, belaying it with the healthy one.

The goal of the following exercises is to form a strong muscle corset around the damaged joint.

Sitting on a hard chair, place your hands on your waist and spread your elbows in opposite directions. Raise your shoulders as high as possible, pulling your head in, then slowly lower them.
Sitting on a chair, press your back to the back. Place your palms on your waist, elbows apart. Make slow movements of your shoulders back and forth to the highest possible level.

At the next stage (after 1-2-3 months after immobilization, depending on how you feel), you can begin more complex exercises, including swings with a wide amplitude, and load training. The third set of exercises helps build strength in the deltoid, biceps and triceps, which in turn restores stability to the joint and minimizes the possibility of relapse.

The shoulder joint is quite mobile, which is why it is susceptible to dislocations and other injuries. A dislocation of the humerus is a displacement of the head of the humerus relative to the glenoid cavity. This injury is often diagnosed in people involved in sports.

It can cause serious complications, so if any injury occurs in the shoulder area, you must immediately contact a traumatologist who can make an accurate diagnosis and prescribe appropriate treatment.

Common causes of shoulder dislocation

Etiological factors, that is, the causes of this injury, have long been studied. In any case, there is an excessive impact of physical force, both directly and indirectly, on the joint.

TO common reasons given pathological condition include:

A fall of a person from any height, in which the landing occurs on outstretched straight arms;
Sports activities. Performing exercises in which the shoulder joints are actively involved (for example, weightlifting, artistic and rhythmic gymnastics, and so on). In this case, there is a gradual stretching of the articular capsule and the ligamentous apparatus that holds the joint anatomically correct position. As a result, any awkward movement leads to dislocation;
Direct blow to the shoulder area. Most often this happens in fights;
Road traffic accidents. This etiological factor can lead to any injury, including dislocation of the humerus;
Diseases of the musculoskeletal system (tuberculosis, arthritis, arthrosis, osteomyelitis, osteodystrophy).

Classification of shoulder dislocations and subluxations

In traumatology, all shoulder dislocations are divided into the following groups:

Congenital. They are associated with disruption of the intrauterine development of the fetal osteoarticular system;
Purchased. They arise under the influence of various pathological factors. This group of dislocations, in turn, is divided into: traumatic and non-traumatic.

Depending on the time of occurrence of the pathology, dislocations are distinguished:

Fresh – the pathological condition arose in the near future. The dislocation lasts no longer than 72 hours;
Stale – the injury has already existed for 3 to 21 days;
Old – the injury occurred more than 3 weeks ago.

Depending on the presence of complications, dislocations are:

Uncomplicated;
Complicated. In addition to dislocation, a fracture, rupture of ligaments and muscles, nerve damage and blood vessels.

Classification based on the location of the humeral head relative to the articular surface:

Front. This type of this pathological condition occurs more often than others, in more than 70% of cases;
Posterior shoulder dislocation is diagnosed extremely rarely, no more than in 1 – 2% of cases;
Lower (axillary). This is the second most common type of shoulder dislocation.

It is also common to distinguish:

Complete dislocation, in this case the articular surfaces are completely separated;
Incomplete dislocation or subluxation. The articular surfaces do not lose contact with each other.

Diagnosis of injury

To make a correct diagnosis, you need to know what symptoms accompany the injury. However, it is often necessary to resort to additional methods research, since shoulder dislocation can be accompanied by numerous complications.

Diagnostic methods that are used to clarify the diagnosis in this case:

Questioning and physical examination of the patient. It is necessary to find out the causes of the injury;
X-ray examination. This diagnostic method is performed for all patients who contact a traumatologist with pathology of the shoulder joint. It helps to accurately determine the type of injury and existing complications;
Computed tomography (CT). In this case, the doctor receives clearer and layer-by-layer images of the injury site. CT scan is performed when x-ray method turned out to be of little information, as well as when preparing the patient for surgery;
MRI (magnetic resonance imaging) helps clarify the type of damage to soft tissues, nerves and blood vessels;
It is advisable to carry out an ultrasound examination if there is a suspicion of the development of hemarthrosis (accumulation of blood in the joint capsule).

First aid

If a person dislocates a shoulder, it is necessary to provide proper first aid. It should be remembered that the joint can be reduced only by a traumatologist. Self-reduction contributes to a significant deterioration of the patient’s condition and can provoke the development of serious complications.

You can learn about first aid for a dislocated shoulder.

First of all, you need to call an ambulance. Before her arrival, first aid measures should be carried out for the victim:

The patient is transported in a sitting position. You can take him to the hospital not only by ambulance, but also by yourself.

Reduction methods

Reduction of a dislocation is carried out only after a thorough diagnosis and adequate pain relief. For these purposes, a 2% solution of Promedol is usually used, and novocaine blockade of the shoulder joint is also performed. With these medicines the necessary relaxation of muscle tissue is achieved, that is, muscle relaxation.

There are many shoulders in traumatology:

Dzhanelidze method. This method is less traumatic, which is why it is used more often than others. The patient is in a supine position on a hard surface. The injured upper limb hangs down. Under the influence of drugs, muscle relaxation occurs, which causes the head of the bone and the glenoid cavity to move closer together. Spontaneous involuntary reduction can often be observed. Otherwise, the reduction is carried out by a specialist;
Hippocratic method. This is the most old way reduction of a dislocated shoulder joint. The patient lies on his back, the doctor is facing him on the side of the injury. The forearm of the diseased limb is clasped with the hands, while the doctor rests his foot (the patient’s injured arm of the same name) on armpit the victim. At the same time, the arm is extended;
For stale injuries it is used Kocher method. This is the most traumatic way. In this case, the help of an assistant is necessary;

Shulyak method. Reduction of the dislocation in this case is carried out by two specialists. One of them performs the reduction, and the other assists;
Cooper method. The victim sits on a chair, the doctor inserts his knee into the patient’s armpit. Take the affected limb with both hands. At the same time, he pulls his arm down and rests his knee on the head of the humerus;
Open reduction is performed if there is damage to the joint capsule or habitual dislocation.

Treatment and recovery after dislocation

If there is damage to soft tissues, blood vessels or nerves, then surgery is indicated. In other cases, conservative therapy is carried out.

After reduction, immobilization of the limb is indicated, that is, a plaster cast is applied. The duration of this stage depends on the severity of the injury, from 3 weeks to 2-3 months.

Anesthesia is carried out for several days after reduction and in the postoperative period. NSAIDs are prescribed to relieve inflammation.

Antibiotic therapy is indicated if surgical treatment has been performed. Antibacterial drugs prescribed to prevent the development of secondary infection.

After removing the immobilizing bandage, restorative measures are indicated:

Exercise therapy prevents the development of muscle tissue atrophy, improves blood circulation and nutrition of the joint. During the period of immobilization, I do exercises for the hand, and then move on to developing the joint itself;
Physiotherapy (electrophoresis, magnetic therapy) helps improve blood flow and regenerate damaged tissue, as well as reduce swelling;
Massage. This recovery method is used to improve the tone and nutrition of muscle tissue.

You can read more about recovery after a dislocation.

Complications and consequences

If you apply in a timely manner medical care the development of serious consequences of injury can be avoided.

Complications that occur with shoulder dislocation:

Ligament rupture. This is a serious complication that prevents effective reduction and requires immediate surgical treatment;
Bone fracture in the area of attachment of the ligamentous apparatus. Such fractures are treated only surgically;
Rupture or compression of blood vessels. This condition leads to malnutrition of the tissues of the limb, massive hemorrhage, and the development of hemarthrosis;
Damage to large nerves. In this case, paralysis of the entire arm or its individual parts may occur.

The consequence of untimely contact with a specialist or inadequate treatment is the development of joint contracture. His motor activity is sharply impaired. In severe cases, there is an inability to raise the arm or move it to the side.

You can find out answers to popular questions about shoulder dislocation.

Shoulder dislocation is detected in 60% of all patients with a similar pathology in another location. Repositioning displaced bones does not prevent relapse of the disease.

Injury to the shoulder joint is the cause of disability, loss of ability to work, and inability to self-care.

What to do when providing first aid

The outcome of treatment depends on what benefits are provided to the victim in the first minutes after the injury.

During this period it is necessary:

estimate general state sick;
provide medical assistance;
provide transport immobilization of the limb;
take measures to transport the patient to a medical facility.

First of all, determine the vital condition important organs and body systems:

central nervous system- whether the victim is conscious or not, how he reacts to the situation and answers questions;
cordially vascular system- presence and frequency of pulse;
respiratory system - absence or noisy breathing.

Having established the general serious condition injured, we must find out the cause and try to eliminate it.

With absence life-threatening injuries, begin providing first aid. When a shoulder is dislocated, the patient is asked to take orally painkillers(Analgin, Pentalgin, Paracetamol), anti-anxiety medications(Trioxazine, Seduxen, Tazepam). Use cardiovascular sedatives(Valerian, Corvalol, Valocordin).

Transport immobilization for shoulder dislocation is mandatory.

The Cramer ladder splint is best suited for this purpose. Two joints are immobilized - the shoulder and the elbow. The splint is preliminarily modeled on a healthy arm. A thick cotton wool pad is placed in the armpit.

In the absence of transport tires, improvised means are used - boards, tree branches, brushwood.

A scarf bandage is used: a square piece of fabric, no less than 1.5 x 1.5 meters in size, is folded diagonally, the ends are tied around the neck, the hand in the scarf is fixed with bandages to the body. Containers with cold water or ice. Transporting a patient with injury upper limb in a sitting position.

Types (classification)

Conclusions about the nature and type of injury to the upper limb are made after an X-ray examination. Distinguish congenital and acquired dislocations. A neonatologist examines and treats congenital shoulder dislocation in children.

Acquired dislocations are distinguished:

Traumatic shoulder dislocations:
1. fresh - no more than 3 days old;
2. stale - from 3 days to 3 weeks;
3. old - over 3 weeks.

Habitual.
free.
Chronic.

Mismatch of articular surfaces, weakness of the ligamentous apparatus, and a large range of arm movements contribute to frequent primary dislocations of the shoulder. Excessive physical effort leads to shoulder injuries in athletes. Dislocation of the shoulder joint in a rowing discus thrower is a professional injury.

Untimely medical care leads to fibrosis, scarring, and thickening of the joint capsule.

An old dislocation of the shoulder joint is a serious injury that requires surgical treatment, unlike a fresh primary dislocation.

In 21-26% of cases, in a patient who has suffered a shoulder dislocation, the injury occurs again. Such habitual injuries appear repeatedly during simple movements - throwing a ball, abducting an arm.

Voluntary dislocations - the patient independently, by muscular effort, separates the articular ends of the bones. A dislocation occurs in the shoulder joint with all the characteristic clinical and radiological signs. Chronic dislocation of the shoulder joint occurs with osteomyelitis, tuberculosis, osteoarthritis due to bone destruction.

Dislocations are distinguished according to the direction of displacement of the head of the humerus:

Front:
- subcoracoid;
- intracoracoid;
- subclavian.
Rear:
- subacromial;
- subspinal.
Lower.

Anterior injuries account for 75% of all shoulder dislocations, lower - 23%, posterior - 2%.

Photo

In the images below you can see anterior, posterior and inferior shoulder dislocations.

Physical therapy in recovery period 4-5 weeks after injury, supplement with massage. Apply simple techniques- stroking, rubbing, kneading the area of the damaged joint. If it is not possible to invite a specialist to your home, they resort to self-massage - massage the patient with a healthy hand or ask a loved one to help.

Massage is contraindicated:

in the first 5-7 days after injury due to severe swelling and inflammation;
at acute diseases, occurring with intoxication, high temperature bodies;
in the presence of a purulent process, skin lesions in the area of the injured joint.

IMPORTANT! For achievement good results Treatment of shoulder dislocations at home requires a clear algorithm of actions, consistent, unwavering implementation of the doctor’s instructions, a positive attitude and the active participation of the patient in all medical activities.

Complications and consequences

Injuries to the extremities are often combined. Anterior shoulder dislocations are complicated in 2% of cases fracture of the tubercle of the humerus, to which the muscles that provide arm rotation are attached.

Often, the manifestations of a tubercle fracture in the early stages of treatment are hidden by the symptoms of a shoulder dislocation. X-ray diagnostics difficult due to the plaster cast. Late detection of pathology is the cause of adverse effects of treatment.

Shoulder dislocations complicated by a fracture of the surgical neck of the shoulder are identified by a characteristic crunch due to displacement of fragments and pathological mobility bone fragments, the presence of hemarthrosis - hemorrhage into the joint cavity. The damaged limb is shortened. There is no symptom of elastic resistance specific to dislocation. The diagnosis is clarified by X-ray examination.

Compression of nerves due to shoulder dislocation.

For shoulder dislocations the neurovascular bundle is compressed. It is necessary to pay attention to the frequency, intensity of the pulse, color skin injured limb.

Damage to the nerve trunks causes numbness in the fingers, weakness and cramps in the arm muscles after a dislocation of the shoulder joint. The axillary nerve is often damaged, so it is necessary to pay attention to the condition and tone of the deltoid muscle, and examine the sensitivity of the skin in this area.

Fractures and dislocations of the shoulder, compression of blood vessels and nerves significantly aggravate the course of the disease and require special treatment methods.

Forecast

The outcome of treatment for shoulder injuries depends on the severity of the injury, the presence of concomitant injuries, the patient's age and other factors.

With uncomplicated dislocations, the prognosis is favorable.

How much does your arm hurt after a shoulder dislocation?: pain stops bothering patients 5-7 days after applying a fixing bandage.

How long does it take for a dislocated shoulder to heal?: average time of limb immobilization - 3-4 weeks, disability - 6-8 weeks, rehabilitation - 1-2 months. When surgically treating irreducible dislocations, the treatment time is lengthened. Immobilization is carried out for 4-6 weeks, ability to work is restored after 2-3 months.

Less favorable prognosis for the treatment of chronic dislocations. The more time has passed since the injury, the more technically difficult it is to perform surgery. Conduct drug treatment, physical therapy. Patients continue to perform homework, capable of self-service.

No less complex problem is the treatment of habitual and voluntary dislocations. Bone grafting operations with autograft (Edina, Andina) lead to poor functional results - joint stiffness varying degrees expressiveness.

Results

A dislocated shoulder is a serious injury. In order for treatment results to be good and the risk of complications and adverse effects to be minimal, it is necessary:

be able to provide first aid for emergency conditions, injuries;
master the techniques of transport immobilization for dislocations and fractures;
do not adjust dislocations yourself without medical and x-ray examination;
if you dislocate your shoulder, you need to know which doctor to contact, remember that in a specialized medical institution you should be seen by a traumatologist.

REMEMBER! Failure to seek medical help in a timely manner, refusal to comply medical recommendations, self-medication - the causes of old, habitual dislocations, the treatment of which is an unsolved problem.

Useful video

In this video, a traumatologist talks about shoulder dislocations and a typical medical history of a patient with this pathology.

Shoulder dislocation is one of the types of injuries in which complete separation of the articulating surfaces of the bones occurs. The shoulder joint is most susceptible to dislocation due to certain anatomical features:

intensity of movements in the joint;
large joint bursa;
small surface for bone articulation.

Another reason for frequent injuries is frequent damage to the shoulder girdle during falls.

Shoulder dislocations are classified into anterior and posterior. Anterior is characterized by displacement of the head of the humerus forward. This often happens when falling, if the blow falls on the hand or elbow.

The posterior one is characterized by the fact that the cartilaginous layer of the capsule moves back. This situation arises in the event of a fall on straight outstretched arms.

Symptoms of shoulder dislocation

Acute pain in the area of the joint location. The development of pain is associated with stretching of the capsule, which contains a large number of nerve endings. Compression of the endings leads to pain. The pain is especially felt if the shoulder joint has been injured for the first time.
Limitation of range of motion. This is due to the fact that the articular surfaces no longer touch and movement in the joint does not occur. This is precisely the reason why the victim cannot make his usual movements.
Positive symptom springy resistance. This sign is associated with muscle contraction in response to painful stimulation. That is, the doctor, when pressing on the axis of the joint, notes the resistance to any of its movements.
Change in joint shape and swelling. Deformation is directly related to the development of edema or hematoma. That is, the joint is externally changed compared to the healthy half.
Development of swelling. The occurrence of edema is directly related to inflammatory reaction in response to damage. It occurs due to the action of inflammatory mediators, namely vasopressors and vasodilators. The plasma passes along a gradient into the joint space.
Forced pose. What is meant here is that the dislocated shoulder, namely the arm on the side of the injury, is not in a natural position. That is, the position in which the pain becomes less.

All these symptoms indicate damage to the shoulder joint. In addition to subjective complaints, to determine an accurate diagnosis, doctors conduct X-ray examination.

What to do if you have a shoulder dislocation?

If there is a suspicion of injury to the shoulder joint, it is necessary to call ambulance. Before her arrival, first aid for a dislocated shoulder is as follows:

it is necessary to ensure complete rest for the victim;
apply ice to the damaged area;
if you have the skills to reduce the shoulder, try to put it in place, this will bring significant relief to the victim;
without reduction, you should not apply a scarf bandage;
give painkillers in the form of analgesics.

Method of reducing the shoulder joint using the Chaklin method:

it is necessary to place the victim on his back;
the hand must be placed along the body;
then you should carefully pull the victim’s arm and at the same time lift it up parallel to the body;
When you lift it up, there should be a characteristic click indicating that the joint has been realigned.

This method is the least traumatic of all the techniques that exist for reversing a dislocation.

Special attention should be given to the force with which the shoulder is reduced. The movements must be smooth and not rough, otherwise a relapse of shoulder joint dislocation will subsequently develop.

Applying a scarf bandage

After reduction, a bandage must be applied to immobilize the limb as follows:

bend your arm at the elbow;
take the scarf with the base of the triangle down in both hands;
place the victim’s forearm on a scarf so that the triangle is behind the elbow;
then you need to tie the free edges around the victim’s neck.

After applying the scarf, analgesics should be given and the victim transported to the hospital.

It is important to remember about such an injury as a fracture of the shoulder girdle. Another article will tell about that.

Habitual shoulder dislocation

This pathology arises due to incorrect and timely treatment shoulder joint injuries. For this reason, restoration of muscle tissue does not occur, as it is necessary. They develop on their surface scar changes. These pathological destructions lead to weakening of the muscular-ligamentous apparatus and the development of joint failure. That is, the supporting apparatus of the joint does not support it adequately. This leads to the development of new injuries.

Habitual shoulder dislocation is characterized by the occurrence of new injuries even in the absence of physical activity.

Shoulder dislocation in a child

Joints in children have greater elasticity compared to adults. Because of this, a child’s hand injury occurs very rarely, only with strong impacts.

Symptoms of a dislocated shoulder in a child are as follows:

acute pain at the site of injury;
swelling and development of edema;
restriction of movements due to pain;
the hand takes a strange, unnatural position.

If the child is small, it is difficult to explain to him what hurts. Therefore, the tactics should be like this:

the general condition of the child should be assessed; a rise in temperature is possible;
you need to inspect the damaged part and compare it with the other side;
on the affected side there will be swelling and deformation, i.e. it will be sharply different from the healthy half;
It is necessary to pay attention to the position of the child’s hand; it will be in the wrong position, perhaps it will be pulled back or to the side.

More detailed information You can read about the symptoms of a dislocated arm in a child in the following article.

Symptoms and treatment of shoulder dislocation

In certain cases, damage results serious consequences. These include neurovascular bundle injury, shoulder fracture, and soft tissue injury.

Symptoms of complicated shoulder dislocation include the following:

intense pain that does not go away for a long time may be a sign of rupture of the joint capsule. This condition requires prompt resolution.
if damaged, a collision of the humerus with the socket of the joint may develop. This leads to the presence of crepitation, i.e. crunching.
strong sharp pain, pathological mobility, deformation, crepitus - all this is characteristic of a fracture of the bones above the shoulder girdle. This complication is quite possible with a dislocated shoulder.
damage to the nerve passing through the area of the upper limb is accompanied by a feeling of numbness in the deltoid muscle. This indicates damage to the axillary nerve fiber.
Damage to the ulnar nerve is accompanied by loss of sensitivity along its fibers. This is accompanied by numbness in the muscles of the forearm and shoulder.

These symptoms are typical for complications of shoulder injury. Some consequences take a long time drug therapy.

Damage to soft tissues due to injury to the shoulder girdle is often accompanied by sprains. The following article contains information about that.

Therapeutic measures

Treatment of upper limb injury depends on each specific situation. If upon admission to the hospital the dislocation can be reduced, then after reduction it is applied plaster cast for a few weeks. If the dislocation cannot be reduced, then surgical treatment is performed.

There are many ways to realign a shoulder. Less traumatic method according to Chaklin. It is used as the first method in shoulder reduction. Any reduction is accompanied by anesthesia.

Surgery used for habitual dislocation and unstable head of the shoulder joint. Thanks to surgical intervention the ligamentous complex is restored, the condition of the joint capsule is improved, and habitual dislocation is eliminated.

One of the operations is open reduction. Due to certain anatomical obstacles, it is not possible to reduce it using the Chaklin method or other methods. In this case, resort to such an operation. It is carried out under anesthesia. Post surgical intervention apply a thoracobrachial bandage. After a week, you can already perform passive movements.

Rehabilitation

After immobilization, movement of the shoulder joint should be avoided. But to reduce muscle atrophy, you need to perform the following movements:

rotational and circular movements of the hand;
clenching and unclenching a fist;
short-term muscle tension of the upper limb.

A month after the injury, you can perform movements such as flexion and extension in the joint.

In addition to therapeutic exercises, physiotherapy is widely used.

This includes:

magnet therapy;
cryotherapy, exposure low temperatures;
mud therapy;
paraffin application.

Physiotherapy has the following effect:

reduction of swelling of soft tissues;
reduction of pain;
improvement of tissue vascularization;
acceleration of regenerative processes.

Rehabilitation is one of important points in the treatment of injuries. Since muscles and ligaments atrophy due to prolonged immobility, they require restorative procedures. That is why therapeutic exercises are used so widely. The muscle frame strengthens, and the joint becomes stabilized in the articular capsule. Another advantage of rehabilitation is the prevention of habitual dislocation.

After the joint has been adjusted, you need to say goodbye to any physical activity. Immediately after a shoulder dislocation and surgery, it is strictly forbidden to strain your back, shoulders and arms. Any physical exercise may lead to undesirable consequences. Professional athletes will have to say goodbye to big-time sports for six months.

The first days after reduction

First of all, after reduction, a bandage is applied to fix the shoulder. This will provide peace and rest for the sore spot, which will take at least a week. If complications occur (problems with soft tissues, repeated dislocation or fracture), then the back, arm and shoulder will be immobilized for a longer period.

In the future, the doctor will tell you how to treat a dislocated shoulder joint. Your doctor may prescribe anti-inflammatory medications.

Return to normal physical activity needs to be carried out long and systematically. This will help protect damaged parts of the body after a shoulder dislocation. At a certain point, you can use an expander and dumbbells: this will help develop the hand, while you cannot fully use the arm after dislocating the shoulder joint. When a shoulder is dislocated, treatment is usually varied, which largely depends on the degree of complexity of the injury.

Surgical intervention for shoulder dislocation

In the very first days, complications after a dislocation of the shoulder joint can be detected. At this time you need to surgery. The following reasons are identified:

repeated dislocation;
fracture after shoulder dislocation;
strengthening a loose joint to prevent re-dislocation;
soft tissue damage after shoulder dislocation;
damage to blood vessels after shoulder dislocation;
tendon damage;
damage to nerve endings.

Surgery may be offered as one of the methods to strengthen ligaments.

Drug treatment after shoulder dislocation

Since the victim experiences enough severe pain, then first of all you need to take an analgesic (for example, Tempalgin). Next, during the process of realigning the joint, you need to give an antispasmodic to drink. Spazmalgon will do. This medicine will not only relax the muscles and remove spasms that prevent the joint from being straightened correctly, but will also numb the affected area.

Among the muscle relaxants after a shoulder dislocation, the following medications are distinguished:

Lorazepam;
Diazepam;
Mindazolap.

You can use one of the following as a pain reliever:

Fentanyl;
morphine hydrochloride;
Hydromorphone
lidocaine (only in those rare cases when the pain is unbearable and other drugs do not help).

Stages of rehabilitation after dislocation

The doctor prescribes certain exercises for each patient to develop muscles and. The duration of the immobilization period and the exercise therapy period varies depending on the age, lifestyle of the patient and the severity of injuries to the shoulder joint. Rehabilitation can take up to six months.

Exercise therapy has the following positive properties:

accelerating the tissue healing process;
accelerating the recovery process of the affected area;
reduction of pain;
reduction of swelling;
resorption of hematomas and improvement of blood circulation;
improving the supply of oxygen to tissues;
faster hit medicinal substances to the required areas.

During gymnastics, the splint or support bandage is removed.

The entire process of further treatment of shoulder dislocation after reduction can be divided into several stages:

Physical exercises used at each stage of rehabilitation contribute to the speedy restoration of the damaged shoulder joint and increase its motor activity.

Physiotherapeutic procedures during rehabilitation

Besides physical exercise, massage and physiotherapeutic procedures may be prescribed.

Physiotherapy procedures useful in the rehabilitation process:

Cryotherapy is cold treatment of affected areas. The temperature should be about minus 30 degrees. Thanks to such cold compresses, blood circulation improves, the body's immune functions increase, which help heal the wound. This procedure is contraindicated if there are peripheral vascular disorders, because A spasm may occur that will block the flow of blood throughout the body. Not recommended this procedure children under five years old.
Paraffin applications help warm damaged tissue. This leads to reduced swelling and improved blood circulation. For malignant tumors, kidney diseases, blood diseases and infectious diseases you need to refrain from this kind of procedure.
Diadynamic therapy is the use of currents with a frequency of up to 100 Hz to influence the human body. Such electric shocks affect nerve endings and block painful sensations. This extraordinary pain reliever can be used if drug treatment no longer helps. It is worth abandoning diadynamic therapy if pacemakers are installed in the victim’s body, and there is also body fat, ulcers, bleeding or epilepsy.
Inductotherapy is the use of a high-frequency magnetic field. It improves metabolism and has an anti-inflammatory effect. But in case of cancer, heart disease, tuberculosis, pregnancy and gastrointestinal diseases, it is better to abstain.
Magnetic therapy. It relieves pain and swelling, and also strengthens the body as a whole and improves metabolism. For bleeding, decreased blood pressure If you are prone to forming blood clots, have fractures, or have implants, you should avoid this type of procedure.

Many people believe that a dislocated shoulder is not that big of a deal. terrible disease and can be treated with skillful reduction alone. But in fact, treating a dislocated shoulder joint is quite long and difficult. The recovery process cannot be ignored, otherwise it may result in incapacity of the back, arm or shoulder. Rehabilitation after a dislocation is a very long process that can take up to six months.

A dislocation of the shoulder joint, the rehabilitation of which took place in full accordance with the requirements of the attending physician, is an ailment that is easily corrected.