Abstract

Introduction: The shoulder is one of the most mobile and unstable joints of the human body. When the head of the humerus pops out of the shoulder blade’s socket called the glenoid it is called dislocation. Shoulder Dislocation (SD) is primarily caused by traumatic injuries especially among elderly falling in bathroom, and among youth by direct blows in sports or vehicle accidents, or extreme rotation, forcing the humerus head out of the socket, often with the arm raised or twisted. Other causes include underlying ligament laxity, electric shocks and seizures, which can cause muscles to contract violently and pull the joint out of place. The powerful force causing a dislocation can easily tear one or more tendons stabilizing the humerus especially the rotator cuff, making them a frequent combination, particularly in older individuals.
Materials & methods: This article aims to report in all five cases shoulder dislocation. Two cases of primary dislocation, one case each of accidental dislocation, chronic dislocation and bilateral dislocation and their management. It shows that in the elderly shoulder dislocation is often associated with a rotator cuff tear and becomes a challenge for rehabilitation.
Outcome: The elderly patient had to undergo arthroscopy, for a trivial injury due to a fall, The young football player needed the labral tear repair arthroscopically followed by mini-open rotator cuff repair and took almost a year to resume his sports. The chronic shoulder dislocation case had temporary relief with cortisone injection but had to undergo rotator cuff repair surgery followed by physiotherapy a year later after three injections, bicycle accident patient had to undergo surgical intervention, physiotherapy to recover complete range of movements in about 16 weeks. Other elderly with bilateral dislocation were treated with closed reduction under procedural sedation, put in sling for immobilization for 6 weeks to allow healing.

Keywords:Shoulder; Head of humerus; Glenoid; Luxation; Sub-luxation; Arthroscopy; Physiotherapy; Xray; MRI; CT scan

Abbreviations: RCT: Rotator Cuff Tear; ROM: Range of Motions