Medical expert of the article
New publications
Long-standing shoulder dislocation: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
An old dislocation is a dislocation that has not been corrected for 3 weeks or more.
ICD-10 code
S43.0. Dislocation of shoulder joint.
What causes chronic shoulder dislocation?
In chronic dislocations, the joint capsule becomes denser, thicker, and loses elasticity. In the joint cavity, fibrous tissue growths appear, covering the articular surfaces and filling the free spaces. Atrophic and dystrophic changes occur in the muscles surrounding the shoulder joint. As the duration of the unresolved dislocation increases, fibrosis, fatty degeneration, sclerosis of the synovial membrane, cartilaginous degeneration, and even ossification of the joint develop even more in the tissues, which leads to the formation of an extensive conglomerate, which in most cases does not allow for the restoration of congruence by a closed method.
Where does it hurt?
What do need to examine?
How to examine?
Treatment of chronic shoulder dislocation
If the issues of diagnostics of old shoulder dislocations do not present difficulties, then the choice of the method of treatment of old shoulder dislocation, guaranteeing full restoration of arm functions, is not always possible. The surgeon's tactics depend on the type of dislocation, its duration, the presence of concomitant diseases and the age of the patient. In young people, the surgeon must try to eliminate a closed shoulder dislocation regardless of its duration. We managed to eliminate dislocations 4 and even 6 months old.
Shoulder reduction is performed under general anesthesia and only in the operating room for the following reasons.
- Firstly, when the axillary artery is involved in the adhesions surrounding the shoulder joint, it may rupture during redressing, requiring urgent surgical intervention.
- Secondly, the shoulder is sometimes reduced relatively easily, but when the limb is loosened, the humeral head slips out of the glenoid cavity. In such cases, two Kirschner wires are inserted transarticularly to prevent the head from reluxing. The wires are removed after 3 weeks. We believe that this method should be used more often, since half of the patients whose old dislocation was corrected at a later stage experienced reluxation on the 3rd to 10th day, and the reduction had to be repeated.
- Thirdly, if closed reduction fails, open reduction is used, about which the patient must be warned in advance.
It is important to remember that the longer the dislocation is, the more complicated and traumatic the intervention and the worse the functional result. Due to the frequent stiffness in the shoulder joint, some surgeons refuse radical interventions and perform palliative ones: resection of the humeral head, arthrodesis of the shoulder joint. In elderly people, soft tissue rigidity develops much faster, so the elimination of old dislocations, even with short terms, presents considerable difficulties and danger. At the slightest risk in this group of patients, manipulations should be abandoned and electrophoresis or phonophoresis of analgesics should be prescribed, starting active development of movements with a gradually increasing volume. The goal is to create neoarthrosis. With sufficient physiofunctional treatment, the results are often better than after surgical treatment. The patient can fully take care of himself and do housework.