Dislocated shoulder - 5
Important Good preparation and adequate sedation/analgesia make these easy.
Follow-up and aftercare
There is much debate about how the patient whose shoulder has been relocated should be treated. There seem to be the general consensus that:
- Young people have a reduced risk of dislocation if their shoulder is immobilised for a period of time (optimum probably about 6 weeks). If this is a recurrent dislocation, the chance of the shoulder healing is low, and therefore immobilisation is not particularly important.
- Old people have a higher risk of developing a 'frozen' (stiff) shoulder, and therefore should be immobilised for a short time before use of the shoulder should start.
Methods of immobilising
These include the
- shoulder brace
- keeping the arm under the clothes
There is debate as to whether the traditional position of immobilising the arm is the optimum position.
Patients need to understand why the shoulder needs to be immobilised, and that this needs to be strict.
Patients suffering recurrent dislocation will probably benefit from surgery to repair the anterior capsule of the joint.
Progressive increase in the range of motion should start. A physiotherapist can guide this rehabilitation.
Once the range of motion is back to normal, further excercises to strengthen the rotator cuff may be helpful