Shoulder Dislocation

Shoulder Dislocation

A shoulder joint dislocation occurs when the humerus separates from the scapula, at the glenohumeral joint level. Considering that the shoulder has a great range of motion, this joint becomes quite vulnerable to this type of injuries.

A shoulder joint dislocation is generally caused by a trauma that occurs with the arm in abduction and external rotation, which causes the anterior displacement of the humeral head, thus leading to ruptures in the articular capsule and the tearing of the glenoid labrum in the lower-anterior portion (Bankart's Lesion).

Depending on the position of the humeral head, joint dislocations may be:
— Anterior
— Posterior
— Superior
— Inferior

When Bankart's lesion occurs, especially in young patients with some ligament laxity, it is likely to occur again, causing recurrent shoulder dislocations (a sign of chronic instability).

Shoulder Dislocation Treatment

• Physiotherapy 

Physiotherapy shows good results when joint dislocation episodes are not frequent and with patients older than 30-40 years old. It aims at strengthening the periarticular musculature (especially on the internal and/or external rotators) and the proprioceptive training so as to stabilise the joint. 

• Surgery 

When joint dislocation episodes occur frequently, open surgery or surgery by means of arthroscopy is needed to stabilise the articulation. 

• Labrum fixation (Bankart repair) 

Bankart repair is an arthroscopy procedure that fixes the labrum zone to restore the articulation's original anatomy. 

It is performed by placing small metallic implants or reabsorbable materials in the anterior-inferior edge of the glenoid, which will serve as anchor points to the highly resistant wires with which the injury will be fixed. 

In order to prevent a recurrence, Bankart repairs require a careful rehabilitation and a 4 to 6 months interval before returning to competition.


• Coracoid transfer (Latarjet procedure) 

This type of procedure is usually indicatedfor young patients (under 20 years old) or high-level contact sports athletes with multiple joint dislocation episodes (>5-6), with associated bone lesions and with ligamentous laxity. 

Most cases require a surgical incision at the front of the shoulder from where a coracoid bone graft is transferred to the anterior-inferior edge of the glenoid, and fixed with a screw and washer. The Bristow-Latarjet Procedure consists in the creation of a bone block that prevents the humeral head from migrating out of the articulation. 

This procedure has a very low rate of recurrence; however, if it is not correctly performed it might result in a slight limitation of external rotation.

We are currently performing this procedure, in some cases, via arthroscopy so as to take advantage of mini-invasive surgery.