Habitual dislocation
Introduction
Introduction Recurrent or commonly known as habitual shoulder dislocation, mainly divided into two categories: one is that you can dislocate the shoulder joint, and then you can get back to the normal position, that is, the patient can perform his shoulder joint freely in and out. The second category is the most common, mainly because of trauma, that is, the sequelae of shoulder dislocation after external force. The first type of habitual shoulder dislocation has no history of obvious trauma, and multiple joints may have excessive stretching and relaxation. For example, the thumb can be easily folded back and touched the forearm. The elbow joint or knee joint is overstretched. The main reason is that the congenital body is loose and the joint is unstable, and it is multi-directional. As for the second category, the habitual dislocation caused by the injury is mostly due to obvious trauma, such as sports injuries, such as too much throwing action, or sudden resistance during the throwing process, judo, wrestling and other physical contact movements. Another example is the accidental movement of the hand with the hand, or the shoulder and the ground, causing dislocation of the shoulder joint, almost all of which are dislocated in the anterior direction. After conservative treatment (joint reduction), dislocation or subluxation occurs again. .
Cause
Cause
The problem is that during the first injury, the important structure (shoulder and labial ligament) that maintains stability in the shoulder joint is torn from the edge of the jaw due to joint dislocation and is peeled off from the bone. After the joint was restored, the injured part did not heal, forming a permanent gap, and the stability of the shoulder joint could not be maintained. More than 90% of the shoulder dislocations are removed from the front. Therefore, the detachment of the scapula and ligament is also located in front of the scapula. This is also the case, and the dislocation occurs in the shoulders for abduction and external rotation.
In addition, the number of dislocations is increased, and the joint capsule in front is also becoming more and more slack, which makes the dislocation more likely to occur. Dislocation once, the joint will be injured once, not only will the articular cartilage wear or peel off, and even tear the upper labial ligament. Most patients do not care about the instability of the shoulder joints in and out. They believe that as long as they pay more attention to certain bad postures or avoid certain activities, they can reduce the chance of dislocation. Some people also think that it takes little time to get out of it once. Some people think that they are more and more self-resetting, and whether their condition has been alleviated. Recently, more and more research reports and our own experience have shown that the shoulder joints are unstable at regular times and accumulated multiple dislocations or subluxations, which will cause the wear of articular cartilage, and there is a great chance of getting the shoulder joint. inflammation.
Examine
an examination
Related inspection
CT examination of bone and joint and soft tissue
Statistics, the first time due to trauma caused by shoulder dislocation, such as young people under the age of 20, then the chance of recurrence and dislocation is 60% to 95%. If it occurs in people between the ages of 20 and 30, the chance of recurrence is 40% to 70%. When it is between 30 and 40 years old, the chance of recurrence is 10% to 40%. If it occurs in young people who like sports, it will recur. The probability can also be as high as 80%. There are two, two and three, one, but after the recurrence of dislocation begins, it will limit the normal activities and movements of many shoulder joints, not only can not engage in many sports and work, even if you carefully and then pay attention, often Dislocation or subluxation occurs inadvertently in activities of daily life, such as pulling heavy objects, wearing undressing, sleeping and turning over. The more times you dislocate, the more likely the shoulder joint will be dislocated, and the more you will self-reset, of course, the range of motion of the joint will be more restricted.
Diagnosis
Differential diagnosis
Habitual joint dislocation should be differentiated from joint dislocation caused by trauma.
The experience of the first shoulder joint dislocation due to injury is very profound, the reason is not only severe pain, feeling the shoulders come out, and then stuck and can not move. Most people need to use the external force (Western medicine or Chinese medicine) to "reset" the shoulder joint. A small number of people can "pull" back with the help of themselves or their companions. In short, after some tossing, "the shoulders that have fallen off have gone back to the sputum. After a few weeks of recuperation, the shoulders have returned to normal function. But one day, the patient does shoulder lift and external rotation during exercise or work. The action of the abduction, in a nutshell, is a similar throwing action. The shoulder joint falls out again, and it is stuck and painful. It can't "get it" back. This is a recurrent dislocation, or it may be a feeling of "card". One voice, the shoulder twisted and suddenly did not listen, but you can turn it back, this is a recurrent subluxation. The probability of dislocation and recurrence is closely related to the age of the first dislocation.
Statistics, the first time due to trauma caused by shoulder dislocation, such as young people under the age of 20, then the chance of recurrence and dislocation is 60% to 95%. If it occurs in people between the ages of 20 and 30, the chance of recurrence is 40% to 70%. When it is between 30 and 40 years old, the chance of recurrence is 10% to 40%. If it occurs in young people who like sports, it will recur. The probability can also be as high as 80%. There are two, two and three, one, but after the recurrence of dislocation begins, it will limit the normal activities and movements of many shoulder joints, not only can not engage in many sports and work, even if you carefully and then pay attention, often Dislocation or subluxation occurs inadvertently in activities of daily life, such as pulling heavy objects, wearing undressing, sleeping and turning over. The more times you dislocate, the more likely the shoulder joint will be dislocated, and the more you will self-reset, of course, the range of motion of the joint will be more restricted.
