Shoulder joint dislocation

• X-ray image of the ankle joint

Synonyms in a broader sense

Acromioclavicular joint dislocation, anterior shoulder joint dislocation, anterior shoulder joint dislocation, clavicle dislocation, Tossy injury, Rockwood injury, collarbone, clavicle, acromion, dislocation Shoulder joint, Osteoarthritis ACG

definition

At a Shoulder joint dislocation it is a dislocation of the lateral end of the Collarbone to the shoulder roof (Acromion) with injury to the stabilizing capsule / ligament apparatus of the Shoulder joint.

causes

The most common cause of a dislocation of the shoulder joint / shoulder joint splintering is the fall on the shoulder with direct force transmission on the shoulder joint. Indirect injury from falling on an outstretched arm is less common. This often leads to a broken collarbone.

Frequent causes of accidents are falls from bicycles, horses or while skiing.

X-ray image of the ankle joint

1. Acromion
2. Clavicle
3. Difference = high-risen collarbone

Symptoms

A split shoulder joint manifests itself in three main symptoms:

• Pain just above the shoulder joint
• Swelling of the shoulders and
• Relieving posture

Typically, an anterior shoulder joint dislocation manifests itself with immediate shooting pain. The person concerned often adopts a relieving posture, as any kind of movement of the shoulder or arm increases the symptoms, such as:

• Overhead movements
• lateral lifting of the arm or
• Arm raising against resistance.

For example, turning the arm inward prevents pain and movement. As a rule, the arm is angled, held in front of the body and supported with the healthy arm as a protective posture. Due to the relieving posture, the shoulder joint is immobilized (which one would also like to achieve with a therapy with a backpack bandage, for example), which leads to significant pain relief. As an immediate measure, you can stabilize the arm in front of the stomach with a bandage or sling.

The consequence of a split shoulder joint is often a capsule tear in the shoulder area. Therefore it is recommended to deal with the following topic: Capsule tear in the shoulder

When the shoulder joint dislocation happened during sport, is the victim usually forced to do so by the pain, the quit sporting activity. Applying pressure to the shoulder region also causes additional pain, which is why that Lie on the injured shoulder can be extremely uncomfortable. In the case of an ankle joint dislocation, the arm can relatively good passive movement This means that another person (e.g. the examining doctor) can perform movements with the injured arm and shoulder without the active assistance of the person concerned. This good passive mobility in an ankle joint dislocation is one important demarcation to a dislocation of the shoulder (dislocation), while passive mobility would also be restricted. Active agility and the Movement possibilities of the affected shoulder or arm are mostly considerably restricted and just still in great pain feasible. Under certain circumstances a partial or complete instability of the shoulder through the Ankle joint dislocation noted become.

Usually a short time after the injury occurs swellingthat extends to parts of the shoulder and upper arm. Sometimes also imagines bruise (Hematoma). By a Cooling with ice can be stronger Tissue swelling and therefore even more pain prevented become.

Appointment with a shoulder specialist

I would be happy to advise you!

Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .

The shoulder joint is one of the most complicated joints in the human body.

The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.

Depending on the severity of the injury, not only the symptoms pain, swelling and relieving posture occur. In some cases it can Collarbone (Clavicle) through the split shoulder joint in his Move positionwhich can be explained by a tear in the affected ligaments of the shoulder joint. So it can happen that the the outer end of the collarbone protrudes upwards and a bulge under the skin forms. However, it is only apparently a raised collarbone, actually is a Depression of the arm or shoulder joint caused by the weight of the arm and the force of gravity for the protrusion of the collarbone. If all of the band structures are completely torn apart, the full image is one Shoulder joint dislocation in front.

For the physical exam, that is "Piano key phenomenon" Proof (pathognomonic) for the presence of a complete shoulder joint dislocation, since one can press the displaced collarbone like a piano key with the finger, but when the pressure is released it immediately springs back up. Sometimes you can hear that the Rub bones together (Crepitation). This usually painful symptom can be caused by the Concealed shoulder swelling be. The extent of the piano key phenomenon is a indirect indication of the severity of the ligament injury with an ankle joint dislocation.

The diagnosis of an ankle joint dislocation can be made by the very typical symptoms are often already suspected. The swelling in the shoulder area, relieving posture and a localized pressure pain over the shoulder joint indicate a splintered shoulder joint. Usually cause Movements between the upper arm and the shoulder blade no pain when the shoulder blade is stabilized. In addition to the typical symptoms, a X-ray examination of the shoulder joint is necessary.

Pain

If the shoulder joint splintered, they often tear as a result Fall on the shoulder the various ligament structures around the joint and the Collarbone.

Depending on how many ligaments are injured and what type of injury it is, the pain can also vary in severity. Especially in the area of Shoulder joint at the far end of the Collarbone severe pain occurs, which then also affects the poor can radiate. Often the pain is so severe that the patient is no longer able to move his shoulder or arm. Often, just hanging the arm down is very painful, which is why the patient usually supports the shoulder in the other hand.

In addition, around the shoulder area too Swelling occur and the shoulder is very pressure sensitive.

Another typical symptom of a complete ankle joint dislocation Grade III according to Tossy is the so-called Piano key phenomenon. Due to the tearing off of the ligaments, the collarbone sticks up so far that it can be pressed down like a piano key and then snaps up again. For the pain, the patient can like medication Ibuprofen or Paracetamol take for relief.

diagnosis

After a medical history and physical exam, a regular X-ray in the Shoulder joint dislocation carried out. In the event of a fall on the shoulder, the shoulder is x-rayed in two planes (from the front (a.p.) and from the side) and, if the examination is suspected, a target image of the ankle joint is taken.

To add to the piano key phenomenon, the X-ray target exposure under stress and be carried out in side-by-side comparison. For this, a weight (10 kg) is wrapped around the patient's wrists, causing the shoulder roof (Acromion) is pulled further towards the foot and a possibly undetected piano key phenomenon is displayed.

Also through the Sonography (Ultrasonic) a shoulder joint dislocation can be diagnosed. In the case of ligament injuries, bleeding in the joint area can be detected (hypoechoic area) and the 3-4 mm joint space can be enlarged in the frontal plane.

Another advantage of sonography is that the shoulder tendons (Rotator cuff) can be examined for an injury. Elderly patients in particular are more likely to suffer from rotator cuff injuries.

-> Continue to the topic of classification of ankle joint dislocation

Tossy classification

The Classification according to Tossy is a graduation of the shoulder joint dislocation. It contains different degrees according to which the severity of the injury is assessed. In addition, this classification is also used to create a Assessment of the indication for surgery deliver. It depends on the Number of injured structures.

At Tossy I lies a strain or partial tear of the capsule and the ligament on the acromiclavicular part of the shoulder. The other bands of the Collarbone are not injured and the collarbone is not higher. There is a widening of the joint space of the Shoulder joint.

At Tossy II is it a complete rupture of the capsule and ligament between Acromion and Collarbone. In addition, the ligaments of the collarbone are torn. This shows an easier one Elevation of the collarbone in the outer area.

At Tossy III Finally, all the ligaments on the shoulder joint and on the collarbone tore, making a more visible Elevation of the collarbone according to the Piano key phenomenon shows. A significant widening of the joint space visible.

surgery

Violations of the Grade Tossy II and III will in most cases operational supplied to especially the following damages like a chronic instability of the joint and also the Tapes to avoid.

The operation takes place endoscopic instead, which is why mostly only small incisions in the skin are necessary for introducing the instruments. The patient receives a general anesthetic. There are various techniques to choose from.

In many patients the ligaments are sewn back together and also through a endogenous tendon (augmentation) from the leg ( Gracilis tendon) additionally stabilized. Also the Joint capsule is reconstructed in the process. The duration of the procedure is often around 60 minutes and the patient can usually leave the hospital on the first or second postoperative day, depending on the patient's condition.

In order to guarantee good healing of the joint, the entire shoulder is then treated with a Orthosis stiffened. This is worn both during the day and at night so that the sewn together Tapes can heal well and also become stable.

In the next three months then the movement is targeted through physiotherapy rebuilt and increased, whereby the shoulder must not yet be exposed to heavy loads. Light jogging is after approx six weeks allowed.

Shoulder joint dislocation

1. Collarbone
2. ACG = shoulder - corner joint
3. Acromion (Shoulder height)
4. Coracoacromial ligament
5. Coracoclavicular ligament

Healing of the splintered shoulder joint

An ankle joint dislocation is usually one benign running injury. Stick with the vast majority of those affected no discomfort or pain back in everyday life and in sports. How much time an ankle joint dislocation takes to heal depends on the degree of injury from. Without surgery, the healing time is usually between 2-12 weeks, until the injured ligament structures restored are.

Ever more pronounced the damage is in the shoulder joint, the sooner must have an operation performed to direct the ankle joint dislocation. This allows the Significantly increase the duration of healing. Wires or plates used during surgery Stabilization in the joint can be introduced after 6-10 weeks away become. This is followed by a physiotherapeutic follow-up treatmentto achieve full healing. Mostly the shoulder is about 12 weeks again after the shoulder joint explosion fully resilient.

The healing process can go through conservative methods of treatment how

• Immobilization of the joint using various bandage techniques
• Physiotherapy in the form of lymphatic drainage
• Electrotherapy
• manual therapy or
• physiotherapy

be promoted. The physiotherapeutic therapy strengthens the muscles surrounding the shoulder joint and promotes resilience. In consultation with the attending physician or physiotherapist, if the shoulder joint dislocates (shoulder-sparing) sports activities can be resumed as soon as the pain subsides, often after 1-2 weeks. In the case of moderate shoulder joint dislocations, you should not do sports for 5-6 weeks in order to allow the partially injured ligaments to heal. Sports in which the shoulder is stressed or in which the hands are raised above the head (e.g. volleyball) can only be carried out again after about three months. Strong tensile and compressive forces on the shoulder should be avoided if possible to prevent setbacks in the healing process.

It can happen that following the healed shoulder joint dislocation

• chronic instability of the shoulder joint
• Osteoarthritis of the shoulder
• Pain or one
• decreased usability of the arm

stay behind. These complications can in turn medicinal, by Injection method into the shoulder joint, with the help of physiotherapy or operational to be addressed.