Rare Case of Voluntary Poterior Shoulder Dislocation Followed By TraumaIn this report, surgeons from The Johns Hopkins University present a rare case involving posterior shoulder dislocation. A 17-year old male on the high school wrestling team dislocated his shoulder during a match. Most shoulder dislocations pop out of the socket in a forward direction. In this case, the dislocation was in the opposite direction (backward).
What made this case so unusual was the fact that before the young man's injury, he could voluntarily dislocate both shoulders. He could also put them back in the joint without help. It's unusual for anyone who can voluntarily dislocate the shoulder in a backward direction to develop instability of the joint after an injury.
In this case, after the wrestling injury, an MRI showed a large posterior tear of the labrum. The labrum is a rim of cartilage around the shoulder socket to help keep the joint in place. A tear of this type and in this location is called a reverse Bankart lesion.
The authors point out how important it is to have a clear diagnosis before treatment. Treatment for traumatic instability is different from treatment for voluntary shoulder dislocation. In this case, the patient had both problems.
Physical therapy and time to heal likely would not help the traumatic injury. Conservative care of this type is often successful for voluntary dislocations. Surgery was needed in order to repair the damage before the patient could return to sports.
Lara L. Devgan, et al. Posterior Dislocation in a Voluntary Subluxator: A Case Report. In Medicine & Science in Sports & Exercise. April 2006. Vol. 38. No. 4. Pp. 613-617.
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