Shoulder Dislocations ,Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 3 авг 2024
- Dr. Ebraheim’s educational animated video describing conditions and treatment associated with shoulder dislocations, the etiology, signs and symptoms, and the prognosis.
For the purpose of shoulder stability, the labrum acts like a bumper within the joint capsule of the shoulder joint. The axillary nerve is most commonly involved in injuries associated with the shoulder joint. It arises from the posterior cord of the brachial plexus and supplies the teres minor and deltoid muscles as well as the skin of the shoulder.
Injury to the axillary nerve will result in
•Numbness in the shoulder area
•Weakness of shoulder abduction
The shoulder joint is the most commonly dislocated joint in the body
Types of shoulder dislocation
1-Anterior dislocation
2-Posterior dislocation
Anterior dislocation
Anterior dislocation is seen in more than 95% of cases involving shoulder dislocation.
The mechanism of injury related to anterior shoulder dislocation is usually indirect force with a combination of abduction, extension and external rotation. It occurs with the arm in a position away from the body, often overhead, with the arm rotated backward.
Anterior dislocation is often found with a combination of labral tear, greater tuberosity fractures or fractures of the humeral head.
Bankart lesion
•Refers to a tear of the anterior-inferior labrum of the glenoid rim.
•Bankart lesions may be associated with a high recurrence rate of dislocation in patients younger than 30 years of age.
•Bankart lesions occur either as fibrous or osseous.
In elderly patients, dislocation of the shoulder is often associated with rotator cuff tears.
The head of the humerus may impact against the anterior-inferior edge of the glenoid causing a divot or flattening of the humeral head.
Treatment of anterior dislocation
•Immediate reduction
•Dislocation is ruled out if the patient can touch the opposite shoulder.
•Immobilization of shoulder dislocations remains a controversial topic in duration and position of the immobilization.
Unable to lift the arm after reduction of shoulder dislocation:
•Young patient think axillary nerve palsy
•Elderly patient think rotator cuff tear.
Surgery is usually reserved for patients with recurrent instability.
Posterior dislocation
•Usually associated with seizures or electric shock and is often missed on radiographs.
•With posterior shoulder dislocation, there is a lack of external rotation movement of the shoulder joint.
•Posterior dislocation will dislocate straight posterior. Only 5% of shoulder dislocations are posterior.
•Normal external rotation of the shoulder is possible without the presence of posterior dislocation.
•The most reliable sign of posterior dislocation is the presence of the shoulder being locked in internal rotation.
•Reverse bankart lesion, reverse hill-Sachs fracture or lesser tuberosity fractures of the humeral head may also accompany a posterior dislocation.
•Axillary radiograph view is used to diagnose posterior shoulder dislocation.
•The humeral head is seen impacted onto the posterior rim of the glenoid.
Inferior subluxation of the shoulder
•Often confused with shoulder joint dislocation.
•Axially radiographic view is normal in these cases.
•Inferior subluxation is caused by:
Deltoid muscle atony
•muscle of the shoulder has lost its strength to maintain the position of the humeral head within the joint.
Treatment is given by physical therapy and electrical stimulation.
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It's shameful how an hour long lecture didn't give as much understanding as this 7 min long video.
I am still amazed tbh..
@Nixon Cooper Lel
I've been haunted by shoulder dislocations for the past couple of years. For anyone who has shoulder dislocation problems, see an ORTHOPEDIC SURGEON. They will set you up to get MRI scans to see what you're problem is, then decide if the best course of action is to take surgery. The key rule is that every time you dislocated your shoulder, it gets easier to dislocate the next time. I hurt myself playing badminton, wrestling, getting into a car, etc. I just had surgery on my right and now it's so much better. Recovery takes so long though: 3 months and then another 3 months to feel normal. Now just waiting for surgery on my right. I wish anyone going through the same thing I did with luck! 😉
Chris Chen Thanks I'm going through the exact same my right shoulder dislocated 20+ times it's very weak and tender . I'm going to the orthopedic surgeon real soon to see why the shoulder keeps dislocating . MRI SCANS should have the answer.
Chris Chen. When did doctor tell you to get surgery
Same here I'm facing the same problem with 7 years now my doctor said operation
Hey bro tell me what the total time of recovery reply fast please...
@@anythingelse8149 how's your shoulder now
I dislocated my left shoulder on the 25th of September 2020 (Friday night) trying to throw a punch (first it impinged, then I stupidly rotated in many ways instead of resting for a couple of hours, and as the shoulder was at its weakest, it just popped out).
Popped it back myself a couple of minutes later (most require a Specialist to do that, and actually it is not good to pop it back yourself even if it hurts, as it could cause several tears that would hurt even for months, which otherwise would not), and tried rotating that shoulder back and forth, not knowing that it was a dislocation, which caused it to dislocate again (yes, twice within just less than 1 hour).
got an MRI which showed that there had been a couple of tears on the rotator cuff (I guess), and did my best to believe that it was not a dislocation, and continued my fast bowling (Cricket-right arm) as usual after a couple of weeks on the Sling and a few more strengthening exercises.
since then, I have had 5 dislocations in total within a span of just 3 months, the latest one being on the 22nd of December 2020, while bowling.
again, spent 1 good week with the Sling, providing it with the best rest that I could, started strengthening exercises (all baby steps) using Resistance bands mainly, starting from the 3rd week, and almost by the mid/end of this January, I started playing again, light bowling (had to change to Spin though), and light batting (left-handed). in terms of batting, I only found the Upper Cut a bit difficult or hurting to play (I mean who even plays that now, except R Sharma).
in regard to sleeping, I have been sleeping all my life turning downwards, so the risks to me of dislocating while sleeping are almost none.
most importantly, have also been able to carry out my favourite workout (CHINUPS, not Pullups) as earlier, although not at the same pace, still, I manage, meaning earlier I used to do like 25 to 30 reps/day, but as of now, only around 15 at most.
adding to it, as of now, I probably am bowling at my full strength (SPIN requires ideally no effort, except for turning and hence, almost no impact on my non-bowling hand-left).
so, despite not having surgery, the workouts that I am now able to do as usual (although, not at the same pace or reps), include Chinups, Pushups, a little bit of Punching.
for instance, the one thing that I loved doing the most was fast bowling, and now I had to give it up and replace it with Spin (as per Cricket bowling, the only bowler I found out to be successfully bowling following a dislocation on his non-bowling arm, and then several surgeries is only Andrew Tye).
there are literally thousands if not hundreds of thousands around the world with missing body part(s), and a dislocation would be ideally nothing (clearly not the end of the world even if you are an athlete) if you could adjust your movements accordingly, and if you do not, it could also make your life a bitch (my dad's had around 25 dislocations since his 1st when serving at the Army nearly 4 decades ago, as he had not put in much effort into rehab).
finally, the only treatment that I got was using a mixture of many Ayurvedic raw materials that was recommended by a local Ayurvedic practitioner, who prescribed them mentioning that they would end the nightmare for good, and the reason why it recurs was that during a dislocation, apparently, whatever those ligaments or liquid-like cartilage things tend to release or fall out of the socket, and once that happens, it will continuously happen (sometimes even after Surgery) following each wrong movement. so, did that treatment for a couple of weeks, and it may also be a major reason that I have not had another dislocation (wouldn't even want to imagine, its that depressing) so far, although, I couldn't really compare the levels of cartilage on my shoulders through a proper scan (ideally an MRI).
the takeaways: providing good rest (although I believe I did not provide enough), proper strengthening and rehab (it's hard nowadays if not impossible though, given this COVID), good nutrition (obviously), particularly good carbs (I ate like a shit ton of Manioc, and my Cancer cells are also now probably gone for good, lol), most importantly not doing anything that you think could lead to a dislocation, like over-stretching, especially throwing, and etc.
following a dislocation (with or without Surgery), the main thing that you have to put into your head is that that particular shoulder is never going to be the same, and so are your movements.
Wait! You had many dislocations of your shoulder and continue with bowling(cricket)? How? Does it not dislocate again? Does it not hurt after dislocation? I had my first dislocation while playing basketball and till now had 3 more dislocations. I have stopped playing any sort of sport that requires shoulder movement. The last dislocation I had was while swimming and although very painful, the doctor reduced it without using any anaesthesia which was a first for me. But I cannot even think of playing any sports without wincing at the thought of dislocating my shoulder again. I am looking for surgery as an option. I do not know if it will help but I want to swim, play cricket and other sports. Dislocation is a curse I feel.
Thank you.
thank you dr nabiel. Often giving extra information that wouldnt otherwise be taught in class and in the textbook itself. I read Apley's, and usually information is not adequate and limited. Saddened by this.
Thank you doctor
Very informative video
You have great knowledge and experience in your field
@AikooTaiko your doc is doing the correct thing
Thank you dr. nabil for animation, now easier to understand
Fantastic video. Thanks!
THANKS
Great video. The animations are really nice supplements to the content of the video. This 7 minute video is better than reading a chapter out of any text.
From a medical student in Egypt ..... a very useful video , please keep them coming !
I always learn something from this channel. Thank you so much
Very thorough explanation. Thank you 🙏🏽
WoW! An excellent educational video! Thank you. Now I understand some things better.
@TheNursepractitioner i will have a website in the near future
thank you
Sir the explanation is very perfect and very experienced knowledge u have... Thanks for this video
Excellent review. Thanks. Loved the graphics. Made everything clear in an otherwise complicated joint!
I loved the humor at the end HAHA! Again thanks for your work it gives people like myself knowledge and purpose. Hopefully we can help and share.
thank you. very informative, off to see the dr. on thursday for an mri read,
thank you! very helpful and concise!
It's very helpful for me. thanks for sharing.
WE PRESENTED THE PATHOLOGY
WE NEED ANOTHER VIDEO FOR TREATMENT
Can I have your clinic phone number please Dr
It's great.
It make me understand easily.
thank you.
all credit goes2 his animation work...brilliant:)10/10
In the last month and a half my left arm has popped out of my shoulder which feels like a partial dislocation since it pops itself back In after a few minutes of excrusiating pain. As of 48 hours ago my right arm did the exact same thing and I've been on a wait list for MRIs
great video to introduce the shoulder dislocation!
I like all these learnings!
thank you so much for this video.
Thank you so much Nabil such a kind soul
Thanks for the video! It was a wonderful visual supplementary tool....
thanks
dr.nabil thank you for sharing your knowledge
You're videos are old and some of the best.
@youngosify THANKS FOR WRITING TO ME
They need to check the condition of the glenoid , the humeral head and the labrum
see if you have a bankart lesion
I hope you went to have yourself examined after this happened! To answer your question, yes it is possible to have had your shoulder put back into place by itself.
thanks for the post i really appreciate it
Dislocated my shoulder around 25 + times in 8 months.
I have a bankart lesion. Very fucked up.
The worst one is when I'm asleep.. I wake up randomly and my shoulder is popped out.
I just had that happen to me two nights ago. I thought I was dreaming for a bit but then realized it was my damn shoulder. That was the breaking point for me though, i'm going in to talk to a surgeon... Hopefully they don't fuck it up anymore than it already is haha
Wtf
That happened to me my sophomore year of highschool football. I had to over compensate with my right and dislocated it as well. Spent most of the season just head butting people
It happens to me often... When I sleep or during my football match... More than 50 times my shoulder had been dislocated
Ehlers danlos
wow!! Awesome videos. I am a PT student and these videos are really helpful.
@perazaper your doc is correct
this is the first dislocation
wait and see
all you need to know is that it hurts like hell. The worst is when it stops for a little bit, and just randomly, after your shoulder somewhat heals a little, it pops out again. That shit hurts
very useful video, many thanks !
Doctor im from mexico, ciudad juarez city, thank u so much for help me to undestand, Great Job! its great really
@AikooTaiko need to see a doc in shoulder surgery and he need to see the glenoid and how much bone is there
may need CT OR MRI ARTHROGRAM
Gratitude to have your videos
love the video, Doc!! Great job!! :)
This was incredibly helpful. Im doing a presentation on Enes Kanter shoulder dislocation from 2013, and the detail regarding the anterior dislocation is simple and easily understandable, especially the mechanism of injury. Thank you
thanks for this educational video!!!!!!
@whatever25 studies showed that the age is important for recurrance of the dislocation
THANKS FOR THE INFO !
All videos are very helpful and easy to remember
excellent educational resource! Is it possible to provide explanation why in case of posterior dislocations the arm is locked in internal rotation?
Coz it can't perform external rotation because of posterior dislocation of head
Sir I am ur big fan sir pls give a comprehensive lecture on total hip replacement and TkR I am very thankful to u.
thank you sir for a nice video
Very nice discussion.
@Leandrozuccarelli sling for 3 weeks is very common for the young patient
@mskn123 ask your doc
but many reasons why shoulder dislocation occur
surgery has a good prognosis
Dear Doctor Ebraheim,
Thank you for your very nice video and your presentation. I have a question about shoulder dislocation. If a patient's arm is pulled upwards at work and jammed on the shoulder blade and shoulder leg so that it is almost vertical in the air, what is this dislocation called in medicine? Thank you very much for your answer. I wish you all the best and please continue with your work.
very informative video.thank u
رائع د.نبيل
شكرا :)
Thank you very much Dr. Nabil Ebraheim.
I am a student who enjoys hands on or visuals. I learn much faster than reading. I also like working with others to learn rather than by myself. These vids help.
Hopefully you will consider placing the watermark logo near the bottom corner so it is not as distracting. Or an intro in the beginning (2 secs) with the logo.
Man, thank you 😭😭❤️❤️
الله يسعدك ، االله يجزاك خير
I found it most educational
Very useful. thanks!
شكرا دكتور على التوضيخ في خلع عضلة الكتف ...امامي وخلفي...جمعة مباركة
i appreciate your video presentation. very nice educational presentation
Dear doc, thanks for the videos really interesting. I underwent three surgeries on my left shoulder, first one was an arthroscopic Bankart (my shoulder was painful for over a year with no dislocation) with one anchor which failed since a few months later my shoulder started to subluxate easily which never happened before this surgery. So a year later I underwent a second bankart with 3 anchors and a year later an acromioplasty because of persistant pain.Now I'm 2 months post op and still in pain
Cost for this surgery sir?
just dislocated my shoulder came here to see how it effects me so thanks for helping
I dislocated my shoulder last week,falling with my son's e-bike, it was half popped-out. Lucky I could fix it myself,
with patience (at least 8 times/51y) also crashes with motorbikes(racing). Good luck.
thank you doctor
great summary doctor!
Good video doctor.
thanke u doctor .. u help me to understand this point
@Cali4niaboy99 the doc will be able to see the bankart repair during the third surgery , the acrmioplasty
the grinding can be from a lot of things
ask your doc the question and give it time
great video 💯
thanks for the video, I dislocated my shoulder for the first time 3 weeks ago! painfull experience..
Sir have you did surgery? How's your shoulder now
Very good explanation congratulations.
sir 4 years ago,During kabbadi sport I had took my shoulder dislocation problem. at that time Dr. said that it is muscular problem,take rest it will be okay. but now I am suffering pain and dislocation occasionally. when I took diagnosis by MRI and CT Scan Dr said to me took operation. please suggests me.what I do because it 4 years before problem.
This is only one of the two places on the internet where I could find information about Anterior Inferior subluxation. X-rays at orthopedic surgeons office plus MRI and I was prescribed Physical Therapy for mild rotator cuff tear and frozen shoulder. After three months of constant pain I went to a Gonstead Chiropractor. First visit was X-rays & exam with three vertebrae adjustments. Then the surprise: he put my shoulder back in place! I had an AI subluxation - it was pretty far down. Too bad that I had to put up with the Physical therapist pulling on my arm for two months while it was out of place! The one month before going to the chiropractor I had simply given up on PT as it had caused so much pain. After 8 weeks of simple chiropractic care I have regained much mobility and am no longer in pain. Also have resolved many other issues related to the nerves in my neck, back and arms. Thank you for clearly explaining about shoulder dislocations!
I have pulled ligaments in my shoulder so sometimes my arm will move out of place slightly and straight back in , but after I'm very sore. Happened to me 4 days ago again. Still in pain. I can lift and rotate my arm for the most part but it results in pain. My brother had something similar but he had actual dislocations and had to get keyhole surgery.is there anything I can try before surgery
Thank you Sir 😊
I dislocated my shoulder a week ago. Was doing pulling and I slipped off and smacked my left elbow and felt something pull out. My friends came to my aid asking if I was okay I said no. Just at that moment it slowly slid back into place.
Although the narrator's accent was a bit heavy, the information was simple and easy to understand. Thank you for the video.
thank you dr
Awesome channel!
thank you
جزاك الله خيرا
I have the sublux problem with both shoulders and am finding some degree of relief and rehabilitation from Physio. BUT, the problem is that I have already had a reconstruction on the right shoulder. This operation over nine years ago has left me in a constant state of discomfort and pain. I am now booked in to see the surgeon (a different one) about operating again on my right shoulder to try and give me some relief.
What do you think??
p.s. I understand if you are too busy to respond :)
Thanks for nice helpful video
You are a wonderful person💐💐💐💐
Thank you sir
Thank you sir :)
im having a problem with recurring shoulder dislocation.And from the radiographics photos i have noted that it is an inferior subluxation.What should i do to stop the recurring
Awesomely informative and perfectly explained! Thank you so much! 😊😊 17/8/2019
I've noticed that you write dates. Why ?
@@utkarshdubeyingoogleplus because i tend to rewatched the video multiple times. easy for me to remember how many times i watch them haha
@@HafizahHoshni Great method!
CHOICE OF TREATMENT VARIES
SEE A DOC
can you dislocate your own shoulder without any impact? I was trying to reach something on the side slight behind me and I had to stretch my arm backwards motion to reach it. Now, my right shoulder feels a bit numb and a bit stiff and the shoulder is positioned slightly forward, I was pretty sure I have dislocation until you mentioned being able to touch my other shoulder. I can perfectly touch my other shoulder but with very minor muscle or bone resistance
@Drrikesh thanks
@nabilebraheim we will do another video for snapping scapula
Sorry to hear that man. I'm still hoping for mine but it feels very unstable. I'm curious how your procedure will go. Let me know what happens if you remember! Thanks and good luck!
How's life man 😉
Nice video Thnx for info sir also my right hand shoulder dislocated from 17 years pls give me great treatment or info
Your right shoulder was discolated 17 years ago? Me too, i think 12 or 13 years ago, i also got injured in basketball, until now i feel pain in my deltoids, and im not comfortable with it, also in my armpit its pain, my biscep i feel something like swelling in my bisceps, and the pain going to my armpit. But not all the time is pain, at night, or cold weather. Like that. Since i got injured , i never tried to consult my doctor. I hope that there will not be bad happen or serious illness.
Nice job