Contact us

Make an appointment

our specialists

 

  01 40 79 40 36

 

secretariat

@chirurgiedusport.com

 

SOS KNEE

 

Sports Clinic

36 bd St Marcel

75005 PARIS

Sports clinic Paris

Metro: Saint Marcel

Parking 6 rue test


sur

'Pages chirurgiedusport :

HONCode

Ce site respecte les principes de la charte HONcode de HON Ce site respecte les principes de la charte HONcode.
Site certifié en partenariat avec la Haute Autorité de Sant├ę (HAS).
Check here

QRCode

Youtube video

Dislocated shoulder rugby player.

Print Article

EMERGENCY TREATMENT IN FIELD

The diagnosis is made ??on the ground. After a fall on the shoulder at the tackle generally, the player complained of a sharp pain in the shoulder, with the failure of the move. It is maintained spontaneously by the opposite arm. Felt a "ball" between the deltoid and pectoralis matching the humeral head dislocated forward. The arm is spontaneously eliminated from the body but can not move because of the intense pain.

Rugby player with a dislocated right shoulder

We must immediately:

1 / Stop the game

2 / Preventing medical aid: always on-site, if not call the 15

3 / Rescue player

 

IT IS STRICTLY FORBIDDEN TO HANDLE ARM ATTEMPT.

If there is a fracture and not a dislocation, the risk is to move the fracture and create irreversible damage to the shoulder.

Then, wait for help to arrive, which will transport the player to an emergency service. Firefighters, a doctor or an ambulance will help the player get up, hold the arm in the position and if the pain allows, protecting it in a scarf, or simply wrap the shirt around the arm.

TO EMERGENCIES

An x-ray is necessary and indispensable to confirm the diagnosis and rule out other diagnoses (including fractures).

X-ray of right shoulder dislocation
Occurred in circumstances

Luxation is the dislocation of the joint between the humerus and scapula.

The plating is involved in 2/3 of cases. Or if it concerns the tackled player (75% of cases), while falling to the ground with direct trauma on the top of the shoulder or at the tackle (25% of cases) with the arm position is reinforced hit by the tackled player. 62% of dislocations are recurrences.

Reminder on the shoulder dislocation:

The dislocation is severe trauma that systematically generates anatomical lesions of the joint.

Most often (90% of cases) the dislocation is in front of the joint, on in the armed movement, arm and elbow back. More rarely, back, arms forward, the elbow directly impacted from front to back.

The consequences of dislocation

The gleno humeral joint (between the humeral bone and shoulder blade) is held by the tendons of shoulder muscles, ligaments, capsular shell, with a reinforcement around the scapula called "bead".

The shoulder is a very mobile joint, in the various spatial planes. This mobility is necessarily accompanied by a risk of instability.

Each dislocation, there is damage to the ligaments of the bead, or lesions type fracture. The passage of the head of the humerus "in force" can lead to fracture of the posterior part of the humeral head and / or front of the shoulder blade.

Others feared complications are fractures and nerve damage. The nerves can be stretched or cut less frequently. Generally, the axillary nerve is stretched: which causes anesthesia of the shoulder and a deficit of forward flexion of the shoulder deficiency of the anterior bundle of deltoid. More rarely, it is all the nerves of the arm called the brachial plexus, which can be stretched or broken, resulting in paralysis of the whole arm.

The risks of dislocation

Recurrence is the main risk. The risk factors and the recidivism rate is well known today: age, gender, type of sport, competition, bone lesions passage, the number of dislocation ..
The under 20 years patients have virtually 100% of recurrence. However, after 40 years, the risk is low, less than 5%. Men have a greater risk of recurrence than women. The armed countered sports (back arm) are particularly exposed.
Playing rugby combines all these risk factors.
 
A rugby player has a very high risk of becoming UNSTABLE after a dislocation.
In fact, if there is not necessarily another dislocation, there is still another form of instability. Ie either subluxations (shoulder back into place alone, without outside intervention), was apprehensive.
There are avoidance behaviors that are particularly frequent with players who "choose" to be plated with a shoulder rather than "fragile", or pillar who prefers to be left and right with unstable right shoulder. Shoulder "free" of the pillar is much risk of dislocation during the collapse of a scrum, while shoulder blocked the fray is locked.
All these phenomena are signs of instability.

Doctor Yoann BOHU, Doctor Serge HERMAN, Doctor Nicolas LEFEVRE. - 2 juin 2014.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

News

Read also ...

Sensitivity and specificity of bell-hammer tear as indirect sign of an anterior cruciate ligament partial rupture on magnetic resonance imaging

Doctor Nicolas LEFEVRE, Doctor Yoann BOHU, Doctor Shahnaz KLOUCHE , Doctor Serge HERMAN.

The most read articles

Technical cruciate ligament

By Dr. Nicolas Lefevre

More videos

Last publications

Feature: knee prosthesis

total knee replacement

Feature: knee ligaments

Dossier: Ambulatory Surgery ACL

Dossier: meniscus

MENISCUS 3D CRACK MENISCUS TEAR SURGERY SPORTS

Feature: Shoulder sportsman

Folder: hip prosthesis

Dossier: break hamstring

Dr. Lefevre proximal anatomie_ischio_jambier_rupture chirurgiedusport

Dossier: prosthetic and sports

hip replacement and knee and sports

Dossier: PRP

Chirurgiedusport - Who are we - Contact us - Legal Notice - Web design Digitaline - EMC2 Studio development - Clinique du Sport