If I dislocated my shoulder, and it needed to be put back in place in the emergency room, what is the appropriate treatment afterwards, and is surgery ever advisable?

Usually a period of immobilization in a sling is the next step--to allow pain to diminish and to allow the soft tissue swelling/trauma to settle down. In order to fully dislocate your shoulder in the front, the capsule and ligaments tear. In most cases, conservative treatment will be successful, and this includes the possibility of needing some physical therapy to help get motion back and to rehabilitate the muscles around the shoulder. Though some research has suggested that a position of "external rotation" better positions the ligaments for healing, wearing a simple sling, with the shoulder in internal rotation, remains the most common practice. Although arthroscopic repair has been suggested acutely, particularly in high demand athletes, conservative treatment is by and large the norm since recurrent dislocations occur in less than 50% of cases; so in short, operating on all first time dislocators would be operating on several patients who would never have had another dislocation or episode of instability. However, when a dislocation occurs in people younger than 40, recurrence is a risk, and if a recurrent dislocation occurs, surgery may then be recommended. In the not too distant past, NBA basketball star Dwyane Wade opted for nonoperative treatment---and he has done very well. If a dislocation occurs after age 40, we need to be less concerned about recurrence, and more concerned about whether the rotator cuff may have torn as a result.

You must be logged in to post a reply. Please login or click here to create an account.