Key points
- Chronic dislocation of the shoulder should be suspected in patients with shoulder pain and decreased range of motion in the context of dementia, alcoholism, obesity, seizure disorders, or multiple trauma.
- A patient with a posterior dislocation is most comfortable in a standard sling and should be fully evaluated.
- A quality axillary lateral radiograph is necessary to rule out dislocation.
- Closed reduction of a chronic shoulder dislocation after 3 weeks can be very difficult, and open reduction should be considered.
- Extensive bone loss should be addressed to improve postoperative stability.
- Posterior dislocations result in anteromedial humeral head impaction injuries, and anterior dislocations can cause both posterolateral humeral impaction injuries and anteroinferior glenoid bone loss.
- Arthroplasty should be considered in patients with greater than 50% humeral head destruction, preexisting arthritis, and low functional status.
Know more about shoulder surgery with Dr. Van Thiel, review the orthopedic conditions and treatments offered at the clinic, and schedule an appointment for an evaluation.