Shoulder Joint Dislocation
Shoulder joint dislocation occurs due to overstretched or damaged capsule, ligaments or cartilage around shoulder joint. Dislocation may be partial or complete. Common type of injury to the shoulder joint is labrum tear. Labrum tear occurs due to falling on outstretched hand. Bicep tendon is attached to the superior part of the labrum. Superior labrum tear occurs when biceps tendon is stretched sharply. This kind of injury occurs in baseball pitchers, golfers, weight lifters and other athletes who are involved in throwing object sharply. This type of labrum tear is known as SLAP (Superior Labrum Anterior & Posterior) tear.
Other type of labrum tear is Bankart lesion. In this type of tear labrum is damaged in it’s anterior part. Pain in this lesion is in the anterior part of the shoulder.
When the labrum tear occurs in the posterior part of the labrum, it is known as reverse Bankart tear. Pain in this lesion is in the posterior part of the shoulder.
Combination of Bankart, reverse Bankart and SLAP tear gives rise to 270 degree of tear to labrum.
Labrum tear sometimes gives rise to paralabral cyst formation. The lesion has one way valve mechanism through which synovial fluid enters the cyst and never goes back. According to the location of the cyst, it presses on surrounding structure mainly nerve like subscapularis or axillary nerve.
Labrum injuries can be diagnosed by combination of clinical examination, radiological tests and shoulder arthroscopy. MRI and CAT scan are important radiological examinations. Shoulder arthroscopy is a very important procedure which not only allows diagnosis of labrum injury but surgical intervention is also possible through arthroscopy to repair the lesion.
If the labral tear is small then labral debridement is done in which frayed labral part is removed in arthroscopy.
If the labral tear is big then special anchors are used to attach the labrum with the underlying bone.
Rotator Cuff Injury
Rotator cuffs are the group of muscles which attache the upper arm to the shoulder blade and are involved in actions like throwing objects, lifting arm, reaching overhead or swimming.
Four muscles form the rotator cuff: Suprspinatus, Infraspinatus, Teres minor and subscapularis.
Rotator cuff injury may be acute due to injury to muscles by fall on overstretched arm.
Rotator cuff injury may be chronic due to tendinitis or impingement syndrome.
Injury may be Partial or Full thickness. In partial tear muscle attachment is not severed. In full thickness tear muscle is detached from bone.
In partial tear conservative treatment is given which includes modification of activity, light exercise, ice application and sometimes local steroid injection. Full thickness rotator cuff are sometimes treated with surgical intervention.