Shoulder Dislocation Anatomy | Shoulder Biomechanics | Sports Injury
6 years ago
The mechanism of injury includes an indirect force to abducted and externally rotated arm (30%). A force directed posteriorly on distal segment or anteriorly on proximal humerus (29%). Forced elvation and external rotation (24%) and a fall onto an outstretched hand (17%).
The subcoracoid anterior shoulder dislocation is the most prevalent. Fractures can be commonly seen with shoulder dislocations. Bony Bankart accounts for 50% of all fractures in a shoulder dislocation. When assessing the athlete on the field - are xrays necessary? Majority of fractures have not precluded, prevented, or complicated closed reduction. Notion that all patients require pre-reduction and post-reduction radiographs has been challenged.
Neurovascular injuries are rare, but can occur with a shoulder dislocation. Premanent axillary nerve damage is uncommon following shoulder dislocation and rarely a result of the reduction method. Age, delayed reduction and the degree of trauma complicate any neurovascular injury.
The soft tissue structures - the Bankart lesion occurs in 97% of the time. Occasionally, the anterior labrum periosteal sleeve avulsion and humeral avulsion of the glenohumeral ligaments can occur with a shoulder dislocation. Rotator cuff tears are uncommon in younger patients, but they can occur.
For the acute management of the shoulder dislocation the athletic trainer should follow a systematic approach. Brief history, inspect, palpation, nurovascular clearance and functionally assess the motor capacity.