Dislocation, glenohumeral

• Shoulder dislocation
• Humerus dislocation

• 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

• 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

• 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Connective Tissue Dysfunction

Description

• 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.

Essentials of Diagnosis

• 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 ...