Glenohumeral Dislocation: Patient Presentation

Question

Answer

Anterior dislocation is the most common, followed by posterior location and inferior dislocation.

Anterior Presentation: 

• The patient holds the injured arm supported at the side in slight abduction and slight external rotation.
• There is an inability to move the arm due to intense pain, especially with adduction or internal rotation.
• There is an obvious deformity of the shoulder, with loss of normal contour of the lateral shoulder and a prominent acromion.  That deformity is palpated as a step deformity (a finger gap between your acromion and your head of the humerus).
• Divided into four types: subcoracoid (most common of anterior dislocation), subglenoid, subclavicular, and intrathoracic (rare)

Posterior Patient Presentation: 

• The patient holds the arm at their side with the shoulder in internal rotation.
• The inability to move the shoulder due to pain, specifically abduction and external rotation, and visible deformity, with prominent acromion and coracoid processes.
• Fullness in the posterior axilla can be detected due to the displaced humeral head.

Inferior Patient Presentation:

• The patient's arm is hyperabducted, with the elbow flexed and the hand in an overhead position.
• Unable to lower the arm due to pain and locking.
• The humeral head can often be palpated in the axilla.

For additional information on this topic, please check out the Glenohumeral Dislocation and Rehabilitation course by Rina Pandya, PT, DPT.