Employ passive motion as soon as the acute traumatic reaction has subsided, usually at the end of five or six days. The arm should be fixed to the side and the forearm carried in a sling. A convenient method is to sew the sleeve of the undershirt to the body of the garment, preventing excessive movement that could strain the capsule. In performing passive motion, avoid external rotation and extreme abduction as these can worsen injury.
The duration of immobilization should be governed by the extent of capsular laceration; prolonged immobility without passive motion leads to permanent loss of mobility. When fracture complicates dislocation, immobilize the arm for four to six weeks until union takes place. Passive motion is not permissible prior to union, though careful massage may begin as soon as the traumatic reaction has subsided.
If joint motion remains restricted after union, break up adhesions by passive motion using anesthetic if necessary. This should only be attempted two months post-injury and when X-ray shows good callus formation at the fracture site.
Key Takeaways
- Initiate passive motion after five to six days of immobilization for shoulder dislocations.
- Avoid external rotation and extreme abduction during rehabilitation to prevent further damage.
- Immobilize the arm for four to six weeks if a fracture is present, allowing proper union before initiating movement.
Practical Tips
- Use a sling or sew the sleeve to the undershirt body to immobilize the arm properly after dislocation.
- Begin careful massage once the traumatic reaction has subsided but avoid passive motion until bone union occurs.
- Monitor joint mobility and seek medical advice if movement remains restricted post-union.
Warnings & Risks
- Avoid external rotation and extreme abduction during rehabilitation to prevent further injury to the shoulder capsule.
- Prolonged immobilization without passive motion can result in permanent loss of shoulder mobility.
- Unrestricted use of the arm before full recovery may lead to recurrent dislocation.
Modern Application
While this chapter provides valuable insights into managing shoulder dislocations, modern medical practices have advanced with better imaging techniques and surgical interventions. However, the principles of passive motion and controlled rehabilitation remain crucial for proper healing and preventing long-term complications.
Frequently Asked Questions
Q: What is the recommended duration before initiating passive motion after a shoulder dislocation?
Passive motion should be initiated once the acute traumatic reaction has subsided, typically around five to six days post-dislocation.
Q: Why should external rotation and extreme abduction be avoided during rehabilitation?
Avoiding these movements prevents further injury by preventing the opening of capsule rents and stretching of injured capsule portions across the head of the bone.
Q: What is the recommended duration for immobilization if a fracture complicates dislocation?
If a fracture is present, the arm should be immobilized for four to six weeks until union takes place before initiating any movement.