Medical Questions » Arms Questions » Question No. 71
| Question: | After falling off a horse, my daughter dislocated her shoulder, but it popped back again quickly. The doctor said it was probably a subluxation and did not require any further treatment. What is the difference between a dislocation and subluxation? |
| Answer: | A dislocation occurs when a the joint surfaces of the two bones forming a joint are completely separated from each other. A subluxation occurs when there is only partial separation.
Shoulder dislocation is the disruption of the joint between the scapula (shoulder blade) and humerus (upper arm bone). The shoulder is a ball and socket joint, but the socket is very shallow to allow maximum movement. A cuff of muscles and ligaments surrounds the joint to keep it in position. This joint can move through a greater range than any other, but as a result is relatively unstable, and it is the most commonly dislocated major joint. If excessive force is applied to the shoulder joint, it may dislocate forwards, or less commonly, backwards.
Patients experience severe pain, do not like the shoulder joint to be moved, and often hold the elbow of the affected arm at right angles and against their side with the other hand. The diagnosis can be confirmed by X-rays.
The dislocated shoulder can be put back into place by one of a number of different techniques, often with little or no anaesthetic if treated immediately, or after giving pain-killing injections or a brief general anaesthetic if there is any delay. After treatmenr the arm is kept in a sling for a month.
Any shoulder dislocation is associated with tearing and damage to the surrounding muscles and ligaments of the rotator cuff and joint capsule, and a dislocation may be associated with a fracture. After a couple of dislocations, recurrent shoulder dislocations may occur by merely picking up a heavy object or raising the arm and these patients require an operation (the Putti-Piatt procedure) to repair the damaged tissues and prevent further dislocations. |
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