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SHOULDER DISLOCATION - Operate or Not?

Surgical Management of Shoulder Dislocation

Introduction

Shoulder dislocation is a common musculoskeletal injury, occurring approximately 20 times per 10,000 individuals annually. While non-operative treatment is often effective, recurrent dislocations are a significant concern, particularly among younger patients and those with high-demand lifestyles. Surgery can be considered for patients with recurrent dislocations, those with concomitant injuries, or those experiencing persistent pain and functional limitations.

Indications for Surgery

Surgical intervention for shoulder dislocation is typically considered in the following scenarios:

  1. Recurrent Dislocations: Patients with a history of two or more dislocations are at a substantially increased risk of future recurrences, reaching up to 90% in some studies. Surgery can effectively reduce the likelihood of re-dislocation, especially in younger patients and those engaged in high-impact activities.

  2. Concomitant Injuries: Shoulder dislocation can sometimes cause damage to surrounding structures, such as the rotator cuff, labrum, or nerves. In these cases, surgery may be necessary to repair the damaged tissues and restore shoulder function.

  3. Persistent Pain and Functional Limitations: If conservative treatment fails to alleviate pain and improve shoulder function, surgery can be considered to improve the patient's quality of life.

Surgical Procedures

Various surgical procedures are employed to address shoulder dislocation and its associated complications. The specific technique chosen depends on the individual patient's anatomy, injury pattern, and treatment goals. Common surgical approaches include:

  1. Capsular Shift Procedures: These procedures involve tightening the ligaments surrounding the shoulder joint to enhance stability and reduce the risk of dislocation.

  2. Labral Repair: The labrum is a ring of cartilage that provides stability to the shoulder joint. If the labrum is torn, it can be repaired surgically to restore joint function.

  3. Rotator Cuff Repair: The rotator cuff is a group of tendons that stabilize the shoulder joint. If the rotator cuff is torn, it can be repaired surgically to improve shoulder strength and function.

  4. Bone Augmentation Procedures: In cases of bone loss or deficiency, bone augmentation techniques can be used to provide additional support and stability to the shoulder joint.

Benefits and Risks of Surgery

Surgical management of shoulder dislocation offers several potential benefits, including:

  • Reduced risk of recurrent dislocation
  • Improved pain and function
  • Shorter recovery time compared to recurrent dislocations

However, surgery is not without risks, and potential complications include:

  • Infection
  • Stiffness
  • Damage to nerves or blood vessels

Decision-Making Process

The decision of whether or not to pursue surgical intervention for shoulder dislocation should be made on a case-by-case basis, considering various factors, including:

  • Age and activity level
  • Severity of injury
  • Response to non-surgical treatment
  • Patient's individual goals and preferences

Conclusion

Surgical management of shoulder dislocation can be an effective treatment option for patients with recurrent dislocations, concomitant injuries, or persistent pain and functional limitations. Careful consideration of the patient's individual circumstances, along with a thorough discussion of the potential benefits and risks, is essential for making informed treatment decisions.

SCOT: Dr.Naveen's Bone and Joint Clinic, Sholinganallur

www.scotortho.com

9094567894, 9094567893

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