Shoulder Dislocation Treatment Singapore

doctor img
Dr Kau Chung Yuan (许医生)

MBBS (S’PORE)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

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What is Shoulder Dislocation?

Shoulder dislocation occurs when the ball of the upper arm bone (humerus) is displaced from its normal position in the socket of the shoulder blade (scapula). This condition can result in pain, unsteadiness, and limited movement of the shoulder joint. The shoulder, being the most mobile joint in the human body, is particularly susceptible to dislocation due to its wide range of motion.

The condition can further be classified as either partial (subluxation) where the head of the humerus is partly out of the socket, or complete where it is completely out of the socket. Both types can cause damage to the surrounding muscles, ligaments, nerves, and blood vessels.

Types of Shoulder Dislocations

Anterior Dislocation

This is the most common type of shoulder dislocation, accounting for approximately 95% of cases. It occurs when the humerus moves forward, causing the arm to be rotated outward and extended.

Posterior Dislocation

Accounting for about 2-4% of shoulder dislocations, posterior dislocations happen when the humerus moves backwards relative to the shoulder socket.

Inferior Dislocation

Rare and constituting less than 1% of cases, inferior dislocations occur when the humerus is displaced downward. This type is often accompanied by a characteristic position of the arm being held up and away from the body.

Causes

Understanding the causes of shoulder dislocation is important in both prevention and treatment strategies.

  • Trauma
    The most common cause of a shoulder dislocation is a traumatic injury. This can include falls, particularly onto an outstretched hand, sports injuries, and direct blows to the shoulder area. High-impact activities or accidents, such as motor vehicle accidents, can also result in dislocation.
  • Sports Injuries
    Athletes, especially those involved in contact sports like football, rugby, or martial arts, and sports that involve falls, such as skiing or gymnastics, are at a higher risk of experiencing shoulder dislocations.
  • Weakness or Instability of the Shoulder Joint
    Some individuals have naturally loose ligaments, leading to increased joint flexibility and instability. This condition, known as joint hypermobility, can increase the risk of dislocation, even from minor injuries or movements.
  • Falls
    Falling onto an outstretched arm or directly onto the shoulder can forcefully push the arm bone out of its socket, leading to dislocation. This is particularly common in older adults, who may be more prone to falls.
  • Repetitive Strain
    Overusing the shoulder joint in repetitive motions, especially in overhead activities, can stretch or tear the ligaments and muscles around the shoulder, increasing the risk of dislocation.
  • Genetic Factors
    There may be a genetic predisposition in some individuals that makes them more susceptible to shoulder dislocations, particularly in cases of joint hypermobility or connective tissue disorders.

Symptoms

Recognising the symptoms of a shoulder dislocation is key to seeking timely medical attention.

  • Visible Deformity
    In the case of a dislocated shoulder, there may be a noticeable deformity where the shoulder appears out of place. The normal contour of the shoulder may change, often looking squared off in the case of an anterior dislocation.
  • Pain
    Intense pain is a common symptom, usually immediate and worsening with movement. The pain is often severe and can be felt deep in the shoulder joint.
  • Limited Mobility
    The range of motion in the affected arm is significantly reduced. The individual may be unable to move the arm or may experience severe pain upon attempting to do so.
  • Swelling and Bruising
    Swelling often occurs rapidly following the injury, and bruising may develop soon after.
  • Numbness and Weakness
    There may be numbness, tingling, or weakness in the arm, particularly around the shoulder, due to the dislocation impacting nerves in the area.
  • Muscle Spasms
    Muscle spasms may occur around the shoulder, further limiting movement and contributing to the pain.

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Diagnosis

Diagnosing a shoulder dislocation involves several key steps:

  • Physical Examination: Initially, the doctor conducts a physical examination to assess the shoulder’s appearance, checking for deformity, swelling, and signs of muscle, tendon, or ligament injury.
  • Medical History Review: The doctor will review the patient’s medical history, focusing on the injury’s circumstances, any previous shoulder issues, and overall joint health.
  • Imaging Tests:
    • X-rays are crucial to confirm the dislocation and identify any related fractures.
    • MRI Scans might be used to evaluate soft tissue damage, crucial for planning treatment.
    • CT Scans provide detailed images, particularly useful for complex cases or to assess bone positioning.
  • Neurovascular Assessment: An examination of the nerve and blood supply to the arm and hand is performed to check for any damage caused by the dislocation.

Non-Surgical Treatment Options

  • Closed Reduction: The initial treatment for a dislocated shoulder often involves a procedure known as closed reduction. This is a manipulation technique where the doctor tries to gently manoeuvre the arm bone back into its socket. This procedure typically provides immediate pain relief.
  • Immobilisation: After the shoulder is back in place, immobilisation using a sling or a special brace is common. The duration of immobilisation varies but typically lasts several weeks, depending on the severity of the dislocation and the patient’s age.
  • Pain Management: Pain relief is vital in the initial treatment phase. Over-the-counter pain relievers, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), may be recommended to reduce pain and swelling.
  • Physiotherapy: This involves undertaking targeted exercises designed to restore the shoulder’s range of motion, strengthen its muscles, and minimise the risk of future dislocations, thereby facilitating a smoother recovery process.
  • Activity Modification: Patients are advised to avoid certain activities or positions that may put the shoulder at risk of another dislocation. This includes avoiding lifting heavy objects or engaging in high-risk sports until the shoulder has fully healed.
  • Home Care Strategies: Applying ice packs to the shoulder to reduce swelling, gentle exercises as advised by the healthcare provider, and proper rest are essential components of the recovery process.

Surgical Treatment Options

In more severe cases, surgical interventions may be necessary to treat a shoulder dislocation.

  • Arthroscopic Surgery
    This is a minimally invasive surgery used to repair or tighten the torn or stretched ligaments that hold the shoulder joint in place. Through small incisions, a camera and surgical tools are inserted to perform the procedure, resulting in less pain and a quicker recovery time compared to open surgery.
  • Open Surgery
    In cases where there is severe damage or complex dislocations, open surgery may be necessary. This involves a larger incision to access and repair the shoulder structures. Open surgery may be more appropriate for individuals with extensive soft tissue damage or bone fractures.
  • Latarjet Procedure
    This procedure is used in cases of severe instability or when there is bone loss from the socket. It involves transferring a small piece of bone with an attached tendon to the shoulder socket to create a more stable joint.
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Dr. Kau Chung Yuan

MBBS (S’pore)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.

He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.

  • Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
  • Master of Medicine (Orthopaedics), Singapore (MMed) 2013
  • Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
  • Bachelor of Medicine and Surgery (MBBS, Singapore) 2004

Prevention Measures

Preventing a shoulder dislocation is as important as treating one. These measures include:

  • Strengthening Exercises: Regular exercises to strengthen the shoulder muscles can provide better stability to the joint. This is especially crucial for athletes and others engaging in shoulder-stressing activities.
  • Proper Technique in Sports and Exercise: Using the correct technique during sports and physical activities can reduce the risk of shoulder injury. This includes proper form when lifting weights, throwing, or performing overhead motions.
  • Avoiding High-Risk Activities: For individuals with a history of shoulder dislocation, avoiding or modifying high-risk activities and sports that increase the likelihood of a dislocation is advisable.
  • Protective Gear: Wearing protective gear during sports or activities that pose a risk to the shoulder can help prevent injury. This includes padding, braces, or other support devices designed for shoulder protection.
  • Ergonomic Workplace Adjustments: For those whose work involves repetitive shoulder movements or heavy lifting, making ergonomic adjustments can help reduce strain on the shoulder joint.

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Patient Feedback

Ethan Chan
Dr. Kau is an exemplary doctor who is experienced in his field and is very patient with his patients. He walked me through the details of my knee condition and addressed all my concerns. Thanks to Dr. Kau, I had a better understanding of my ACL and MCL injury and the various treatment options available. His advice and treatment have been very valuable to me.
Ming Lee Chua
Dr Kau was very careful and explained clearly the surgery procedures. After surgery, the care while I was in hospital was closely monitored and he even came during weekends! The hip so far has recovered and healed. His ‘predictions’ of when what can happen are so accurate. Trust him.
Teo Pek Suan Diana
I had a very successful total hip replacement done by Dr Kau 4 years ago. 4 months after the operation I was back walking, cycling and swimming. The beautiful job gave me much confidence Dr Kau is most professional and has such great doctor patient communication.

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    Frequently Asked Questions (FAQs)

    How Long Does It Take to Recover from a Shoulder Dislocation?

    Recovery time varies depending on the dislocation’s severity, treatment method, and individual health. Typically, non-surgical recovery may take several weeks to a few months, while surgical recovery can extend from several months up to a year.

    Is It Possible to Permanently Fix a Dislocated Shoulder?

    Treatment, whether surgical or non-surgical, significantly reduces the risk of recurrence. Absolute guarantees are rare, but adherence to medical advice, rehabilitation exercises, and preventive measures can greatly improve long-term outcomes.

    Are There Any Long-Term Effects of a Shoulder Dislocation?

    Possible long-term effects include chronic pain, stiffness, and an increased risk of arthritis in the joint. Regular follow-up and adherence to rehabilitation exercises can help mitigate these risks.

    After a Shoulder Dislocation, When Can I Return to Normal Activities?

    The timeline for returning to normal activities varies. Non-surgical recovery typically allows for a gradual return to normal activities within several weeks to a few months.

    Following a surgical procedure, the timeline might be longer. It is important to follow your orthopaedic surgeon’s advice and complete physical therapy to restore strength and mobility.