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Abstract: The shoulder joint is the joint formed by the humeral head and the scaphoid glenoid. Shoulder dislocation is usually caused by violent injury. In this case, a skiing collision caused shoulder pain, swelling, and limited movement, and the patient was diagnosed with shoulder dislocation after seeking medical attention and taking X-rays. After restoring the shoulder joint alignment, the shoulder pain and swelling subsided and the shoulder movement returned to normal.
Basic information】Male, 25 years old
Disease Type】Subluxation of shoulder joint
Hospital】Harbin First Hospital
Date of Consultation】December 2021
Treatment plan】Manipulation and fixation
Treatment Period】7 days of inpatient treatment, 1 month of outpatient follow-up
Results】The pain and swelling of the shoulder joint subsided, and the shoulder joint movement returned to normal.
I. Initial consultation
The patient hit an object while skiing and fell backward, causing the shoulder to abduct and rotate, tearing the shoulder capsule and causing dislocation of the shoulder joint. During the physical examination, it was found that the shoulder joint had an obvious square shoulder deformity, the humeral head was protruding below the rostral process, the original contour of the shoulder was completely lost, and the shoulder glenoid had an obvious feeling of emptiness.
II. Treatment history
The patient had a typical deformity after dislocation of the shoulder joint, accompanied by limitation of shoulder joint movement and severe pain. The patient was kept in a lying position, and the upper limb on the affected side was traction by the physician while in abduction. The patient was fixed by an assistant using a towel under the axilla on the affected side, and the direction of traction was opposite to that of the physician, and the two were confronted for about 1 minute. The patient’s shoulder muscle strength decreased, and the humeral head was repositioned using the foot stirrup method to restore the anatomical relationship of the shoulder joint, and the patient’s pain symptoms were quickly relieved and the shoulder deformity disappeared. The affected upper limb was fixed in a neutral position using a forearm sling suspension. The patient was instructed to make a fist 500 times a day to speed up the repair of the shoulder joint injury.
III. Treatment effect
The shoulder joint dislocation was cured through shoulder joint repositioning and fixation, and the shoulder joint pain, swelling and limitation of movement were significantly improved, and the original square shoulder deformity was also released. With the help of the rehabilitation doctor, the patient gradually recovered the forward flexion, abduction and posterior extension of the shoulder joint. The patient was discharged after 7 days of hospitalization and was followed up in the outpatient clinic for 1 month. Initially, the rotational movements were still limited, but as the condition continued to recover, the rotational movements of the shoulder joint could be completed independently. Daily life and work were not restricted, and light sports could be completed, but upper limb antagonistic sports, such as basketball and rugby, could not be participated in temporarily to avoid recurrence of dislocation.
IV. Precautions
We are glad that the patient’s pain is relieved and the shoulder joint activity function is restored after treatment. If the patient has symptoms such as shoulder joint deformity, pain and activity restriction again after discharge from the hospital, he/she needs to go to the orthopedic outpatient clinic as soon as possible to follow up and confirm whether the shoulder joint is dislocated again. If the shoulder joint does not recover well after dislocation, the rupture of the joint capsule cannot be completely repaired, the stability of the shoulder joint will continue to decrease, and habitual dislocation of the shoulder joint will easily occur, resulting in impaired function of the shoulder joint. Patients should strengthen the deltoid muscle group exercise in daily life to enhance the stability of the shoulder joint. After the shoulder joint is repositioned, the patient should cooperate with the doctor for continuous fixation and rehabilitation training to speed up the shoulder joint repair and protect the important structures such as articular cartilage and glenoid lip.
V. Personal insight
The patient’s shoulder dislocation was related to the trauma to the shoulder joint. The humeral head broke through the joint capsule under external force and dislocation occurred. It is also important to note that frequent shoulder dislocations can cause serious consequences such as tearing of the glenoid labrum and damage to the articular cartilage, so frequent shoulder dislocations need to be avoided in daily life.