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  • Shoulder dislocation
  • Humerus dislocation

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  • 831 Dislocation of shoulder
  • 831.0 Closed dislocation of shoulder
  • 831.00 Closed dislocation of shoulder, unspecified
  • 831.01 Closed anterior dislocation of humerus
  • 831.02 Closed posterior dislocation of humerus
  • 831.03 Closed inferior dislocation of humerus
  • 831.09 Closed dislocation of shoulder, other
  • 831.1 Open dislocation of shoulder
  • 831.10 Open dislocation of shoulder, unspecified
  • 831.11 Open anterior dislocation of humerus
  • 831.12 Open posterior dislocation of humerus
  • 831.13 Open inferior dislocation of humerus
  • 831.19 Open dislocation of shoulder, other

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  • S43.006A Unspecified dislocation of unspecified shoulder joint, initial encounter
  • S43.016A Anterior dislocation of unspecified humerus, initial encounter
  • S43.026A Posterior dislocation of unspecified humerus, initial encounter
  • S43.036A Inferior dislocation of unspecified humerus, initial encounter
  • S43.086A Other dislocation of unspecified shoulder joint, initial encounter
  • S43.109A Unspecified dislocation of unspecified acromioclavicular joint, initial encounter

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Description

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  • Humerus can dislocate anteriorly, posteriorly or inferiorly out of the socket.
  • Excessive translation of the humeral head in one or more directions
  • The instability may be associated with dislocation or subluxation associated with a trauma event.
  • GH instability may also be secondary to atraumatic factors associated with structural, postural, or movement dysfunction and possibly from recurrent minor injury to the structures of the glenohumeral joint.2-4
  • Symptomatology and management is different depending on the onset, degree, frequency, direction, associated pathology, neuromuscular control, and premorbid activity level.4
    • Anterior or anterior inferior instability
      • Mechanism
        • 95% of traumatic shoulder instabilities4
        • Can result in dislocation or subluxation
        • The humerus is forced into extreme abduction and external rotation and/or horizontal abduction.
        • Associated pathology includes Bankart lesion (anterior), humeral avulsion of GH ligaments (HAGL), and Hill-Sachs lesion.
      • Symptoms
        • Anterior and inferior shoulder pain
        • Instability and apprehension to abduction, external rotation and horizontal abduction motions
    • Posterior Instability
      • Mechanism
        • 5% of traumatic shoulder instabilities4
        • Can result in dislocation or subluxation
        • A fall on an outstretched arm of movements of extreme horizontal adduction or internal rotation
        • Associated pathology includes disruption of the posterior capsule, tearing of the teres minor, and reverse Hill-Sachs lesion.6
      • Symptoms
        • Posterior shoulder pain
        • Instability and apprehension to flexion, horizontal adduction, and internal rotation
    • Multidirectional instability
      • Mechanism
        • May occur without episode of trauma, however, patient may have a history of traumatic dislocation7
        • Can result in dislocation or subluxation
        • Instability and apprehension are present in multiple directions, although one direction may be the primary direction of instability.
        • Associated pathology depends on the primary direction of instability, duration of instability, and history of trauma.4,7
      • Symptoms
        • Pain and instability are often determined by the direction of primary instability and can vary based on activity.

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Essentials of Diagnosis

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  • Diagnosis is made primarily by clinical examination, however, imaging is often necessary to rule in or out associated pathology.
  • Anterior instability is the most common followed by multidirectional and then ...

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