Shoulder Dislocation
Overview
肩部脱臼是最常见的肩部损伤之一, 尤其是年轻运动员和从事身体接触运动的人.
要了解这种损伤，首先要了解肩膀的结构. 肩关节是球窝关节, 然而，肩膀的解剖结构允许惊人的灵活性. The head of the humerus (upper arm bone) is a ball that sits in the glenoid cavity (shallow socket) of the shoulder blade. Because the socket is so shallow, the shoulder relies on the surrounding soft tissues for stability. The labrum (cartilage lining the socket) and capsule (containing joint fluid and several ligaments) provide a majority of the shoulder's stability. 肩袖和肩胛骨的肌肉也有帮助.
Shoulder dislocation most commonly occurs when the arm is moving forcefully away from the body and rotating externally, 比如扔棒球的动作. The humeral head is pulled out of the front of the glenoid cavity – either partially, 哪一种叫肩膀半脱位, or entirely, 哪一个叫肩膀脱臼. Although some people are able to get the humerus back into the joint themselves, 许多人需要在急诊室做手术.
A shoulder dislocation usually also injures the front of the labrum (resulting in what doctors call a Bankart lesion) and the humeral head (a Hill-Sachs lesion).
Vulnerability to a repeat dislocation or related shoulder injuries depends on a person's age. Athletes under the age of 30 have a high risk of dislocating the shoulder again. 这种风险随着年龄的增长而降低. People over 50, however, have a higher chance of a shoulder dislocation causing a rotator cuff tear.
我们治疗肩关节脱位的方法
Awards & recognition
-
是全国顶尖的十大赌博平台排行榜之一
-
全国最好的骨科护理之一
Signs & symptoms
肩膀脱臼的人可能会经历:
- Severe pain
- Swelling
- 关节不能活动
- 肩前或肩后可见的肿块
- 在肩部和手臂以下有暂时的麻木或刺痛
Diagnosis
Doctors usually diagnose a dislocated shoulder by taking the patient's medical history and performing a physical exam. X-rays are commonly taken when a patient is first seen for the dislocation as well as after the shoulder has been put back into place. The images can show whether the humeral head or glenoid cavity has any significant injury.
有些病人还需要核磁共振成像, 这样十大赌博平台排行榜就可以检查肩膀是否有其他损伤, 比如唇部损伤或者肩袖撕裂.
Treatments
The first treatment for a dislocated shoulder is for a doctor to put the upper arm bone back into the shoulder socket, 能迅速缓解疼痛吗. 简单的治疗方法，比如敷冰袋, taking oral pain medication and wearing an arm sling for a few weeks can further reduce pain and swelling. Patients usually participate in a course of physical therapy to stabilize the shoulder. In many cases, these measures allow patients to return to prior levels of activity.
对于多次脱臼的病人, 或者从事会增加另一次脱臼风险的运动, 手术可能是一种选择. The procedure is usually performed arthroscopically (passing slender instruments through small incisions to visualize and treat the joint), 病人当天就可以回家了. Patients are under general anesthesia (completely asleep) and receive a nerve block (an injection that interrupts pain signals in the area), 哪种能减轻术后疼痛. 手术过程包括将关节阴唇修复回关节盂, 这样肩膀就不会再脱臼了. Following surgery, patients wear a sling for four to six weeks, allowing the tissue to heal.
完全康复的一个重要部分是参加物理治疗. 大多数患者在手术后一到两周开始一个项目. 一开始, the focus will be on maintaining the shoulder's ability to move while still protecting the repair. After six weeks, patients can taper their use of the sling and progress toward active range-of-motion exercises. 一旦活动恢复，患者就开始加强肩部的力量. They can generally resume contact sports and other more risky activities around six months after surgery.
这取决于他们的肩关节病史, 有些病人需要不同的治疗方法, either an open surgery (a traditional type of procedure) or surgery to address injury to the shoulder socket's bone. For those who have had prior surgery to stabilize the shoulder or numerous prior dislocations, surgical options may include a Latarjet coracoid transfer (moving a piece of bone from the shoulder blade to the front of the socket to stabilize the joint) or a reconstruction of the shoulder socket using bone from elsewhere in the patient's body or from donor bone. 我们的外科护理团队仔细检查每位患者的病史, 检查结果和影像学检查以确定最佳选择.
常见问题
- 手术后我什么时候可以洗澡?
You'll need to keep the incisions clean and dry until your first post-op visit, 手术后一到两周. At that time, 你可能会被允许洗澡, though you should wait three to four weeks after surgery before submerging the surgical site in a bathtub or swimming pool.
- 我什么时候有后续预约?
You'll see your doctor 手术后一到两周 for an exam and suture removal.
- 肩部稳定手术后我什么时候可以开车?
你会被吊起来，前六周不能开车. You can resume driving after that, so long as you have appropriate control to do so safely.
- 我什么时候可以回学校或工作?
Most patients are ready to return to school or desk work five to seven days after surgery. 如果你能在家工作，你最初的恢复期会更容易. If you have a physically demanding job that requires overhead lifting or strenuous arm work, you'll need more time for a safe recovery and medical clearance before returning to work.
- 我什么时候可以重新参加娱乐活动?
Most patients are able to resume playing sports and pursuing other physical activities about six months after shoulder stabilization surgery.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
