Shoulder dislocation

Last updated: October 10, 2023

Summarytoggle arrow icon

Because the head of the humerus is substantially larger than the glenoid fossa, shoulder dislocation is the most common type of joint dislocation. The head of the humerus can dislocate completely or partially (subluxation) in three directions: anteriorly (most common), posteriorly, or inferiorly. Shoulder dislocation is usually the result of trauma. Typical symptoms include pain and restricted range of motion. Examination reveals a palpable dent in the shoulder caused by the empty glenoid fossa, while the head of the humerus may be palpable inferior to the glenoid fossa. X-rays of the shoulder in two views are necessary to rule out fractures and confirm the diagnosis. With adequate analgesia and muscle relaxation, the head of the humerus can be carefully repositioned into the glenoid fossa through various maneuvers. Reduction is followed by immobilization and subsequent physiotherapy. Patients with concomitant soft tissue lesions or recurrent shoulder dislocation may require surgery to stabilize the shoulder joint. Possible complications of shoulder dislocation include neurovascular damage (most commonly axillary nerve palsy), continued instability, restricted range of motion, and rotator cuff injury.

Epidemiologytoggle arrow icon

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Classificationtoggle arrow icon

Clinical featurestoggle arrow icon

Posterior shoulder dislocation is frequently overlooked during clinical examination!

Diagnosticstoggle arrow icon

Treatmenttoggle arrow icon

The primary aim of treatment is to reposition the humeral head into the glenoid cavity and restore full range of motion. This may be achieved by either closed reduction or surgical repair.

Continuous neurovascular monitoring/evaluation before and after reduction is important for prevention and early detection of axillary nerve and artery damage!

Complicationstoggle arrow icon

We list the most important complications. The selection is not exhaustive.

Prognosistoggle arrow icon

  • High rate of recurrence
  • After rotator cuff repair, the rate of recurrence is significantly lower.

Referencestoggle arrow icon

  1. Zachilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am. 2010; 92 (3): p.542-549.doi: 10.2106/JBJS.I.00450 . | Open in Read by QxMD
  2. Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation.. Ann R Coll Surg Engl. 2009; 91 (1): p.2-7.doi: 10.1308/003588409X359123 . | Open in Read by QxMD
  3. Fiorentino G, Cepparulo R, Lunini E, et al. Posterior shoulder fracture-dislocation: double approach treatment. Our experience.. Acta Biomed. 2016; 87 (2): p.184-90.

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