Dr. Lox on Shoulder Dislocation and Trauma
Sometimes things run in spurts. Including diagnoses. Recently Dr. Lox saw multiple shoulder dislocations in a week. All different causes. Some were sports injuries, while others were just bad luck traumatic injuries. All had shoulder labral tears as a result of the shoulder dislocation. One was extremely severe. It included nerve injury to the brachial plexus.
Shoulder Dislocation and Labral Tears
The shoulder is held in place by cartilage covering known as the glenoid labrum. This is further surrounded by a tendinous structure known as the rotator cuff. In order for the shoulder bone (the humerus) to come out of its socket, something has to tear. Pure and simple. This is usually the cartilage lining known as the glenoid labrum and or the rotator cuff. MRI scans of the shoulder after dislocation often reveal these tears. Dr. Lox has seen several patients with recurrent shoulder dislocations, who self reduce or put their shoulder back in the socket, who have not had MRI’s yet. Just because the shoulder goes back in the socket does not mean the tissue damage has not occurred. Mel Gibson in the Lethal Weapon movies glamorized this action. However, violent joint tearing is not glamorous. It leads to shoulder joint arthritis at an earlier age. This is why patients seek out a consultation with Dr. Lox.
Shoulder Dislocation and Brachial Plexus Injury
When the shoulder is dislocated, in addition to tears to the glenoid labrum, rotator cuff, and surrounding ligaments, the brachial plexus may be damaged. The brachial plexus is a complex network of nerves which arise from the spinal column and merge to form branches underneath the collar bone, then branch further into local nerves into the arm forming specific functions. An example is a median nerve in the forearm and wrist involved in carpal tunnel syndrome. When the shoulder is dislocated, the trauma can affect surrounding tissues including ch the brachial plexus. The brachial plexus is also often injured after severe collar bone fractures, such as in a motorcycle wreck. The three branches of the brachial plexus have different functions. This means depending upon which branch is injured different arm functions are affected. Knowledge of neuroanatomy allows the physician to understand what branch has been affected, by various weakness patterns, or in severe cases, paralysis of muscle groups. This patient with traumatic shoulder dislocation had weakness of his upper arm and hand. Indicating diffuse brachial plexus injury. Over months, his upper arm strength of the bicep, triceps and deltoid muscle returned, yet his hand was weak and the muscles surrounding the hand were atrophied.
This was a poor prognosis for his hand.
Dennis M. Lox M.D. and Sports and Regenerative Medicine
Patients with shoulder dislocation, seek consultation with Dr. Dennis Lox for several reasons. One is returning to sport. Once a shoulder is dislocated due to tissue injury, it is prone to do this again. Many sports make this hazardous. A Regenerative Medicine approach utilizing stem cell applications is focused upon tissue repair and regeneration. The desired outcome for athletes desiring to return to sport. Another reason for Regenerative Medicine after shoulder dislocation is to deter, prevent or alter degenerative arthritis progression associated with trauma. Trauma accelerates degenerative arthritis progression, so a Regenerative Medicine procedure which may alter this progression is extremely valuable. Lastly, patients may not wish to have shoulder surgery that requires a lengthy recovery, and a lot of pain associated with it, when a Regenerative Medicine treatment can replace it with no downtime, and minimal pain. The practicality of rehabilitation without surgery, and utilizing Regenerative Medicine treatments such as stem cell science applications is very appealing to many patients.
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