page_title: Dislocated shoulder
section_title: Surgery
hierarchical_section_title: Dislocated shoulder / Treatment / Surgery
caption_attribution_description: English: MRI of shoulder after dislocation with Hill-Sachs lesion and labral Bankart's lesion. Deutsch: MRT der Schulter nach Schulterluxation nach vorne unten mit Hill-Sachs-Delle am Humeruskopf und labraler Bankart-Läsion.
context_page_description: A dislocated shoulder is when the head of the humerus is out of the shoulder joint. Symptoms include shoulder pain and instability. Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve.
  A shoulder dislocation often occurs as a result of a fall onto an outstretched arm or onto the shoulder. Diagnosis is typically based on symptoms and confirmed by X-rays. They are classified as anterior, posterior, inferior, and superior with most being anterior.
  Treatment is by shoulder reduction which may be accomplished by a number of techniques. These include traction-countertraction, external rotation, scapular manipulation, and the Stimson technique. After reduction X-rays are recommended for verification. The arm may then be placed in a sling for a few weeks. Surgery may be recommended in those with recurrent dislocations.
  About 1.7% of people have a shoulder dislocation within their lifetime. In the United States this is about 24 per 100,000 people per year. They make up about half of major joint dislocations seen in emergency departments. Males are affected more often than females.
context_section_description: In young adults engaged in highly demanding activities shoulder surgery may be considered. Arthroscopic surgery techniques may be used to repair the glenoidal labrum, capsular ligaments, biceps long head anchor or SLAP lesion or to tighten the shoulder capsule.
  Arthroscopic stabilization surgery has evolved from the Bankart repair, a time-honored surgical treatment for recurrent anterior instability of the shoulder. However, the failure rate following Bankart repair has been shown to increase markedly in people with significant bone loss from the glenoid (socket).  In such cases, improved results have been reported with some form of bone augmentation of the glenoid such as the Latarjet operation.
  Although posterior dislocation is much less common, instability following it is no less challenging and, again, some form of bone augmentation may be required to control instability. Damaged ligaments, including labral tears, occurring as a result of posterior dislocations may be treated arthroscopically.
  There remains those situations characterized by multidirectional instability, which have failed to respond satisfactorily to rehabilitation, falling under the AMBRI classification previously noted. This is usually due to an overstretched and redundant capsule which no longer offers stability or support.  Traditionally, this has responded well to a 'reefing' procedure known as an open inferior capsular shift. More recently, the procedure has been carried out as an arthroscopic procedure, rather than open surgery, again with comparable results. Most recently, the procedure has been carried out using radio frequency technology to shrink the redundant shoulder capsule (thermal capsular shrinkage); while long-term results of this development are currently unproven, recent studies show thermal capsular shrinkage have higher failure rates with the highest number of cases of instability recurrence and re-operation.
caption: MRI of shoulder after dislocation with Hill-Sachs lesion and labral Bankart's lesion.
exif: {}