It is a shallow joint, consisting of the head of the arm and the scapula of the scapula, the stability of which depends mainly on the correct, dynamic operation of the tendons and the integrity of the cartilage lip.
The labial cartilage helps to focus and stabilize the head of the arm. When he breaks, as can happen in a fall or during sports or athletic activity, then the shoulder becomes unstable and dislocated, that is, it comes out of position.
“The patient who is injured in the shoulder will need to be treated by an orthopedist, who will initially make a closed reduction. In other words, he will reposition the head in its correct position, having done a simple x-ray before, which will rule out a possible fracture. The orthopedist will then usually order an MRI scan and sometimes a CT scan. The correct study of the MRI and the complete clinical examination will lead the specialist to decide on the correct treatment of a shoulder dislocation. “Treatment can be conservative or surgical.”
There is an algorithm (ISI Score), which leads the thinking of a specialized orthopedist whether to suggest conservative or surgical treatment. The factors that the orthopedist considers are:
• The age of the patient
• His athletic activity
• If he is involved in contact sport
• If it has loose ligaments in the shoulder
• If he has visible Hill-Sachs and / or Bankart on plain face x-ray.
Conservative treatment includes physical therapy, regaining full range of motion, special shoulder stabilization exercises and strengthening all the muscles surrounding the shoulder (rotator cuff). The safe return to sports after conservative treatment is estimated at about one year.
“Surgical treatment, which is performed on a large percentage of patients arthroscopically, involves repairing the lesions and anatomical suturing and reattachment of the cartilage lip into place. “Rehabilitation after shoulder arthroscopy is very short and the return to sports -after the necessary physical therapy rehabilitation program- is safe after about 3-6 months”, concludes Mr. Intzoglou.
Writes:
Mr. Konstantinos Intzoglou, MD, MSC, PhD,
Orthopedic Surgeon, Director of the 1st Orthopedic Clinic – Sports Injuries, Arthroscopy and Minimally Invasive Orthopedic Surgery of the Metropolitan General
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