recurrent dislocation of the shoulder

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The shoulder joint is designed more for movement than for stability - the articulation of the humeral head with the glenoid is minimal, and stability is conferred by the soft tissues of the shoulder. In dislocation the soft tissues are, by definition, disrupted.

There are two tyes of reccurrent dislocation. 5% are not associated with trauma and occurs in teenagers with general joint laxity. These are often bilateral, dislocation occurs in all directions and they are treated by rehabilitation. 95% result from trauma often resulting from a Bankart lesion. In this second type, dislocation usually occurs in one direction, often anteriorly, and surgical repair may be required.

Dislocation may occur on minimal activity - eg abduction and lateral rotation.

The apprehension test, where the patient reacts in self preservation when the examiner attempts to recreate the situations responsible for dislocation, is a useful diagnostic aid.

Damage to the shoulder joint may be seen on radiograph.

Last reviewed 01/2018

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