Shoulder Dislocation

Diagnosis/Definition

• Complete displacement of the humeral head from the glenoid fossa often caused by direct trauma.  First time dislocations may require external force for reduction.  Severe dislocations can have associated brachial plexopathies and vascular compromise.

Initial Diagnosis and management

• History and physical exam.
• Plain radiographs (AP and lateral axillary, internal and external rotations).
• MRI/CT not indicated.
• Reduction should only be performed by a medical specialist trained in this procedure.
• Immobilize the shoulder for 2 weeks or until seen by therapist.
• Ice as needed for pain and swelling.
• NSAIDs.
  • Adults - 200 to 400 milligrams (mg) every four to six hours as needed for up to 2 weeks. Example: Ibuprofen
  • Take tablet or capsule forms of these medicines with a full glass (8 ounces) of water.
  • Do not lie down for about 15 to 30 minutes after taking the medicine. This helps to prevent irritation that may lead to trouble in swallowing.
  • To lessen stomach upset, these medicines should be taken with food or an antacid.
• Appropriate activity limitations.
• 72-hour consult to Physical Therapy (routine TRICARE Consult).

Ongoing Management and Objective

• In cases not requiring, surgical intervention early mobilization and progressive rehabilitation usually results in the ability to return to full activity within 10 weeks.

Indication a profile is needed

• Any limitations that affect strength, range of motion, and general efficiency of upper arm, shoulder girdle, and upper back, including cervical and thoracic vertebrae.
• Slightly limited mobility of joints, muscular weakness, or other musculo-skeletal defects that may prevent hand-to-hand fighting and disqualifies for prolonged effort.
• Defects or impairments that require significant restriction of use