Shoulder Dislocation Repair

A shoulder dislocation involves the "ball" or humeral head dislocating or coming out of the "socket" or glenoid. The shoulder can dislocate out the front (anterior) or back (posterior). There is usually an associated tear in the labrum, which is a soft tissue bumper that goes around the socket to help stabilize the head. Additionally, sometimes a small fracture occurs at the rim of the socket. Immobilization followed by physical therapy is often successful for treatment, but sometimes if the shoulder remains unstable the labrum and any bony components need to be fixed surgically.

Biceps Tendon and Labral (SLAP) Repair

The biceps tendon can be injured at its attachment at the top of the socket (SLAP tear), its intra-articular portion, and its extra-articular portion just outside the joint. Pitching and other overhead activities result in the humeral head exerting a shear force on the superior labrum and biceps attachment, which can result in tearing. The biceps runs in a bony groove in the front of the humerus at the shoulder level and certain forces can result in tearing or inflammation of the tendon at this level and extend into the joint portion. Physical therapy and anti-inflammatory medications can often help with symptoms, but persistent symptoms can sometimes warrant surgical repair or debridement. This could include repairing the biceps anchor, debriding the biceps, or actually cutting out the torn or inflamed portions of the biceps and moving its attachment to the humerus.

Shoulder Separation (AC joint) Repair

There are ligaments between the end of the clavicle and the shoulder blade to keep the clavicle close to the body. These ligaments can be injured, usually from a direct fall onto the shoulder, causing the end of the clavicle to stick up. This is a shoulder separation or acromio-clavicular joint injury. It can usually be treated without surgery; however, if there is persistent pain or very high grade separations, surgical repair can be performed.

Pre-operative and post-surgical radiographs of a patient who sustained a high grade AC joint separation, treated acutely with a hook plate.

This video reviews AC joint separation and one surgical option for repair.