Shoulder Dislocations

#traumafiction Topic: Shoulder Dislocation


What is it?


A shoulder dislocation occurs when the humeral head (ball of the shoulder) pops out of the shoulder socket. Ligaments and muscle may also be affected, depending on what caused the dislocation. A traumatic dislocation, such as from a fall or car accident, is more likely to cause additional damage to the shoulder structure. 


What does it feel / look like?

The patient will have a visibly lower shoulder on the affected side. She will have trouble moving or rotating her arm or shoulder (range of motion). She will feel pain or discomfort in any position, but more so if she tries to move her arm. People instinctively hold their affected arm with the good arm. Supporting the affected arm side against the body provides relief until a reduction can be performed. 

She may hear or feel a 'pop' when the shoulder dislocates.

 See how the left shoulder is lower than the right & looks misshapen? 

How can I fix it?

Placing the humeral head back into the socket is called a shoulder reduction. This can often be performed without medical care, so depending on the scene you are writing, your character/patient may be able to do this herself or with the help of a friend. 

A simple method for shoulder reduction is the modified Milch method. The video below show the modified Milch method. (sorry, I couldn't get the video to place on the blog)

http://www.youtube.com/watch?v=vZm79QqCrz4

In addition to this, if the shoulder doesn't pop back in by making the arm straight, the patient can attempt to reach behind her neck and that often does the trick. 

 
 What happens next?

The patient will have immediate relief once the shoulder is back in place. She may have a sore shoulder or difficulty with normal range of motion for a few days. To speed healing, you can place your patient in a sling for a few days to allow the muscles/ligaments to heal.


 Complications?

Unfortunately, once you dislocate your shoulder, you're at risk for doing it again. If the collarbone was broken in addition to the shoulder dislocation, reduction will be exceptionally painful and may not work without surgical intervention.