Shoulder dislocation

Introduction Dislocation of the shoulder joint is less common. One of the reasons is that there is strong muscle group protection behind the shoulder joint, which is difficult to be pulled backwards. Even after dislocation, it is easy to retract due to the tensile stress of the posterior muscle group, so it is rarely clinically see.

Cause

(1) Causes of the disease

Indirect violence or direct violence can cause dislocation.

(two) pathogenesis

1. Direct violence: refers to the force from the front of the joint capsule directly acting on the humeral head to cause posterior dislocation. This is the case when many houses were collapsed during the collapse of the house, and one of the authors was involved in the Xingtai earthquake. This may be related to the fact that the local houses are mostly covered with wooden beams.

2. Indirect violence: When the shoulder joint falls in the inner rotation position of the hand, the humeral head can protrude to the rear and penetrate the posterior wall of the joint capsule to escape.

an examination

Related inspection

CT examination of bone and joint and soft tissue

After dislocation of the shoulder joint, there is no obvious square shoulder deformity as in the case of anterior dislocation. The Dugas sign is also negative. The shoulder joint activity is limited and the anterior dislocation is not as obvious. The typical signs of posterior shoulder dislocation are condylar and shoulder. Obviously, from the side of the injured side, the front of the shoulder is flattened, the back of the shoulder is more prominent, the front side of the shoulder is emptied, and the shoulder abduction and external rotation activity is limited.

In the clinical case, suspicious cases should be taken through the chest or sacral X-ray film. If necessary, shoulder CT scan should be performed to prevent missed diagnosis.

Differential diagnosis

Limited shoulder movement: limited shoulder activity, more common with periarthritis and shoulder dislocation.

Shoulder and joint pain: shoulder pain is the main stage in the acute phase; shoulder joint dysfunction is the main stage in the chronic phase. Shoulder joint pain, limited mobility, often can occur in the upper limbs lifting shoulders, internal rotation and back bending and other movement obstacles, affecting the daily movements such as combing hair, unbuttoning buckles. The tenderness of the shoulder is obvious. After a few months, the shoulder muscles are atrophied and calcification may occur.

Sustained severe shoulder pain: often caused by dislocation of the shoulder joint. There is a clear history of trauma.

Shoulder: The shoulder of the computer is called shoulder periarthritis (now less used), commonly known as the frozen shoulder. It is a chronic injurious inflammation of the shoulder muscles, tendons, bursae and joint capsules. Due to hyperplasia, roughness and internal and external adhesions, it is clinically characterized by pain and function limitation during activity.

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