Treatment of shoulder dislocation and shoulder subluxation

- Jun 10, 2020-

Treatment of shoulder dislocation

After dislocation, it should be reset as soon as possible. Choose an appropriate anesthesia (brachial plexus anesthesia or general anesthesia) to relax the muscles and make the reduction painless. The elderly or those with weak muscles can also be administered under analgesics (such as 75-100 mg dulentin). Anesthesia is not necessary for habitual dislocation. The resetting technique should be gentle, and the brutal technique is forbidden to avoid additional injury such as fracture or nerve damage. Introduce two common methods.

1. Foot pedaling method is suitable for the situation with less manpower. The patient with shoulder dislocation lies on the side of the low bed, the rescuer stands on the affected side of the patient with shoulder dislocation, holds the forearm of the affected limb with both hands, and uses the heel (right foot for right dislocation, left foot for left dislocation) to kick in the dislocated armpit Inside, the rescuer exerts both hands and feet at the same time, while pulling the affected limb with the foot pedal, and slowly rotating the upper arm outward to reset. After reduction, the forearm was held up with a triangular scarf, and the upper arm was fixed on the chest wall with a bandage for 3 weeks.

2. Traction and massage is the first aid for shoulder dislocation. This method requires three people to cooperate. The patient sits, one assistant holds the armpit of the affected side with both hands, the other assistant holds the wrist of the patient with shoulder joint dislocation, and abducts the affected limb by 30-40 degrees. The two assistants pull and pull the affected limb, and slowly rotate the affected limb, The surgeon held the shoulder with both hands and pushed the humeral head toward the glenoid to reset.

 

Surgical reduction

There are a few cases of shoulder dislocation that require surgical reduction. The indications are: anterior shoulder dislocation combined with long biceps tendon slippage hindering manipulative reduction; avulsion fracture of the large humerus tuberosity, the fracture piece stuck in the humeral head and joint Those affected by reduction of the glenoid; those with surgical neck fractures of the humerus that cannot be corrected; those with fractures of the coracoid process, acromion, or shoulder glenoid, and significant displacement; those with large axillary injury.

 

Treatment of habitual anterior dislocation of shoulder joint

The habitual anterior dislocation of the shoulder joint is more common in young and middle-aged adults. The cause is generally considered to be damage after the first trauma dislocation. Although it is reduced, it has not been properly and effectively fixed and rested. The purpose of surgical treatment is to strengthen the anterior wall of the joint capsule, prevent excessive external rotation and abduction, and stabilize the joint to avoid relocation. There are many surgical methods, the more commonly used are the subscapular muscle joint capsule overlapping suture (Putti-Platt's method) and the subscapular muscle extraterritorial movement (Magnuson's method).