Institute for Sports Medicine Frankfurt Main

Traumatic shoulder luxation / dislocation
- frequently front Luxation (front instability)

1. Risk kinds of sport:

Combat sport, alpine sport, handball, gymnastics, snowboarding

2. Anatomy:

The shoulder joint is a ball joint (relatively small pan with large upper arm head). It is a muscle-led joint

3. Function:

Large mobility three-dimensional in all directions combines diffraction/aspect ratio, a spreading, interior/external rotation, circulation

4. Injury mechanism:

no direct injury mechanism!
- Fall on the hand or elbow with spread arm
- Fall on the shoulder
- abrupt arm movement (against unexpected resistance)
- the arm get caught during throwing motion (reaching into the arm)
- strong throwing (only with previous damage relevantly)

5. Symptoms:

- active movements not possible
- passive movements very painfully
- asymmetrical shoulder outline in the comparison to the opposite side (bad position)
- empty joint socket
Note:
possible collateral injuries:
- Nuritic damage
- vascular damage
- initial tearing of the tendon insertion
- bony - and gristly injury

6. First measures:

- Immobilizing
- immediately in the hospital/physician to set a bone (= straightening)
- if no independent Reposition possible is, immediately in the hospital/to the physician to the Reposition

7. Diagnostics:

- clinical investigation by the physician
- Roentgen

8. Therapy:

a) Conservative therapy
- Antiphlogistika (anti-inflammatory, decongestant)
- Physiotherapy
- Bandage only at the beginning
b) Operational therapy:
- becomes today already after the 1. Luxation an operational (arthroskopische) treatment (Stabilization) recommended.

9. Physiotherapy / rehablitation:

- Electrical therapy
- Lymphdrainage
- Patient gymnastic (Mobilization and Stabilization after end of immobilizing)
- Cryotherapy

10. Prevention:

- Strengthening the shoulder belt musculature, particularly into the front range (Innenrotatoren); favorably: closed chain (supporting training)

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