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04.11.2013

Shoulder dislocation surgery, how can i get rid of my belly fat - PDF Review

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The shoulder has unique and complex anatomy that allows range of motion and coordination needed for reaching, lifting, throwing, and many other movements. With an anterior dislocation, the head of the humerus is driven forward from inside the glenoid cavity to a place under the coracoid process. When the shoulder dislocates posteriorly, the head of the humerus moves backward behind the glenoid.
Tears or ruptures of the rotator cuff are the most common injuries that lead to shoulder dislocation.
Once the shoulder has been dislocated the first time, there is a high probability (90 per cent chance) of a second shoulder dislocation (recurrence).
Most people with a shoulder dislocation experience sudden, severe pain in the shoulder after a fall, injury, or other traumatic event.
With an inferior dislocation, it is difficult (and sometimes impossible) to bring the arm down to the side. If surgery is being considered, then the surgeon may perform a diagnostic arthroscopic exam. One simple technique to reduce an anterior shoulder dislocation is done in the prone (face down) position. If passive positioning doesn't work for an anterior dislocation, then a general anesthetic is administered and traction is applied to the upper limb.
Some patients who have recurrent dislocations know how to pop the joint back in place without help. Recurrent dislocation is the most common complication after dislocation, especially in young people. If the shoulder can't be reduced manually or if a sling and rehabilitation program does not control symptoms of instability, then surgery may be suggested.
Even when surgery is needed, your surgeon may have you see a physical therapist for several visits before the surgery. There are many different ways to repair a chronically unstable shoulder following a first dislocation or after many recurrent shoulder dislocations. Shoulder reconstruction surgery may be done with an open incision method or with the aid of an arthroscope.
Older adults who have a fracture and shoulder dislocation may need a shoulder replacement instead of shoulder reconstructive surgery to reduce the dislocation and repair the fracture. As your symptoms ease and strength improves, you will be guided in specialized exercises to improve posture, shoulder stability, and normal motor control. You can return to your sporting activities when your muscles are back to nearly their full strength and control, you are not having swelling that comes and goes, and you aren't having problems with the shoulder popping out of the joint.
Most doctors have their patients take part in formal physical therapy after shoulder reconstruction. Most dislocations are anterior (forward) but the shoulder can dislocate posteriorly (backwards). The bones of the shoulder are the humerus (the upper arm bone), the scapula (the shoulder blade), and the clavicle (the collar bone).


The main shoulder joint, called the glenohumeral joint, is formed where the ball of the humerus fits into a shallow socket on the scapula.
The sternoclavicular (SC) joint supports the connection of the arms and shoulders to the main skeleton on the front of the chest.
An inferior dislocation describes the position of the humeral head down below the glenoid cavity.
Forceful abduction, external rotation, and extension are the most common load resulting in shoulder dislocation. The force of the first dislocation dislodging the head of the humerus forward leaves a pocket formed by sagging soft tissues that the humeral head can slip back into. This type of apprehension is present when instability remains after the shoulder has been reduced (manually put back in place).
Any of these injuries in the shoulder complex can lead to (and will be present along with) shoulder dislocation.
When there is a shoulder dislocation, the normal rounded contour of the shoulder and upper arm is lost. A positive apprehension test is very diagnostic of an unstable shoulder that might dislocate again after a first dislocation injury. Several views may be needed to reveal the exact direction of the dislocation and fracture lines when present. A log, thin scope with a tiny fiber-optic TV camera on the end is inserted into the shoulder joint, allowing the orthopedic surgeon to look at the structures inside the joint directly.
The arm is held in a position of shoulder abduction (away from the body) while lateral (sideways) and backward pressure is applied to the head of the humerus.
This is done to reduce swelling, strengthen the muscles, and stabilize the shoulder as much as possible before surgery. Incisions are usually still required with arthroscopic technique, but the surgery doesn't require the surgeon to open the joint. Range-of-motion exercises should be started right away with the goal of helping you swiftly regain full movement in your shoulder. The scapulothoracic joint is formed where the shoulder blade glides against the thorax (the rib cage). Posterior and inferior shoulder dislocations only account for about five to 10 per cent of all shoulder dislocations.
Muscles, ligaments, and the bony anatomy of the shoulder all work together to maintain shoulder stability and prevent dislocation. A fall on an outstretched hand or directly on the posterolateral aspect (back and side) of the shoulder can cause an anterior dislocation. Some people with very lax ligaments can dislocate the shoulder and reduce it over and over. Many health care professionals (especially those trained in emergency procedures) know how to manipulate the shoulder back into the socket.
When conservative care is unable to restore shoulder stability and normal function, then surgical intervention may be needed.


Restoring normal motion and function and preventing recurrent dislocations are important outcomes of surgical intervention.
This practice also reduces the chances of scarring inside the joint and can speed recovery after surgery. The site, type, and extent of damage are major determining factors in how the surgeon approaches the repair. The arthroscope is used to view the inside of the shoulder joint as the surgeon performs the work.
Symptoms are addressed in the acute phase but restoring normal function rather than eliminating symptoms is the focus for chronic shoulder instability. The specific type of dislocation is based on the position of the humeral head in relation to the glenoid (shoulder socket) at the time of the diagnosis. Understanding the remaining anatomical structures discussed will help you understand why your shoulder dislocated. This joint is important because it requires that the muscles surrounding the shoulder blade work together to keep the socket lined up during shoulder movements.
In the shoulder, the joint capsule is formed by a group of ligaments that connect the humerus to the glenoid. These muscles help raise the arm from the side and rotate the shoulder in the many directions. Violent uncoordinated muscle contractions during a grand mal seizure can also cause shoulder dislocations. Under anesthesia, the shoulder is rotated outwardly and forward pressure is applied on the dislocated humeral head.
The soft tissues must be given enough time to heal and form scar tissue to support and stabilize the shoulder joint. After a second dislocation, frequent recurrence of shoulder dislocation can occur with less and less force, load, or stress. For example, instead of the greater tuberosity (bony bump along top of shoulder), there is a gap under the acromion. At that point, the test is considered positive for shoulder instability and therefore discontinued.
The labrum creates a deeper cup for the ball of the humerus to fit into and helps prevent dislocation. The rotator cuff muscles and tendons also help keep the shoulder joint stable by holding the humeral head in the glenoid socket. The head of the humerus may be observed and felt as a large bump in front or behind the shoulder.



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