Correlation between extent of BPI and length of dislocation time??

[Suzie]

Hi!
Question for everyone--do you know if there is a direct (or any!) correlation as to the severity of BPI in relationship to the length of time a shoulder is traumatically dislocated before it is re-located back into socket? My husband David sustained a severe TBPI 7/16/2003 after dislocating his shoulder(threw it out throwing a softball! history of 3 rotator cuff surgeries over past 10 years) and the ER left it dislocated (and him in SEVERE pain--but that's a whole other story altogether-don't get me started) for 3+ hours and didn't address the peripheral neurological or circulation status at all--even when we kept telling them that David could feel NOTHING from just above his elbow down-we found he had a severe stretch injury via EMG a couple of weeks later, but he has pretty significant wrist and hand involvement-thankfully improving slowly, we hope!! Anyway, I am an RN, and with the research I have been doing, and just good ole common sense, I truly believe that David's severity of strech injury would be less if they had acted more promptly compassionatly and professionally in the ER and dealt with the pain and relocated his shoulder quicker!--and I worked there in L&D for 13 years and knew the system, etc.!! What if I hadn't been there to be an advocate for my husband?? I cring to think about the people that go there seeking help with no medical knowledge, or nobody to advoacte for them....but I digress...sorry!! If anyone has any ideas or know of somewhere I can get this information, I would appreciate it----just curious, and would like to prove a point to the ER staff if what that correlation proves to be true!! Have a great day!!

[admin]

I absolutely believe there is. I also was screaming in pain, numb, etc, but they left my shoulder dislocated 24 hours. The x-ray was read wrong by the ER doctor and I saw the ortho doctor the next morning and he took one look at my shoulder and his jaw dropped. He put me on the x-ray table and reduced it in his office (with no sedation at all), but I felt so much relief after he reduced it. I cannot tell you how much pain I was in for 24 hours. I went from being told I would recover in 3-4 days to almost 3 years later, 3 surgeries, I am left with very little use of my hand and very limited feeling from the elbow. Of course it is much better than it was. At first it was totally flaccid. I had no movement at all in my fingers for eight months. Bent the elbow at about 6 months. I had about 300 PT/OT visits in 2 years. Please feel free to e-mail me.

Kathy

[Suzie]

Hey Kathy!!

thanks for your reply--I agree with you too and am going to pursue this further--already have David's medical records from tne hospital--that was a fiasco trying to get them--nobody wants to give up medical records to a lay-person, so I had to pull "the nurse card"--and that it was our RIGHT to have those records, etc--I got them then!!! ha! Anyway, am trying to put some sort of time line together from what I KNOW happened because I was there, and what the chart says happened--bottom line so far is that David's shoulder was dislocated for at least 4 hours, he didn't get pain relief for 45 minutes at least(and only then because I was a royal B%@#^%#$ and pain in the A%@#!!, nobody seriously addressed his neurological or circulatory status, and the chartwork is a disgrace--and to think I worked at that hospital for 13 years!! Will let you know what I find out from an orthopedic shoulder specialist and the BPI guy--hope all is going better for you--thanks for taking your time to answer me!
Suzie

[Suzie]

Hi!!
Thought I would re-post this question to all out there---really would like to know if there is some correlation between the amount of time with a shoulder dislocation and the extensiveness of BPI injury post-reduction of the shoulder???? I think there is-------- Anybody????
Thanks!! ~~~~~~~Suzie~~~~~~~~

[admin]

Suzie

This might or might not be a little bit off the subject you're talking about. What really is the difference of a dislocated shoulder and a shoulder subluxation? I thought that a subluxation was in regaurds to a vertebrae coming out of position as in rotating so the spinous process was not directly dorsal or that the entire vertebrae was pushed anterior or posterior. On the other hand, I thought that dislocation was when a bone was separated from it's joint. My Dr. said I have shoulder subluxation, so Suzie, how is that different from David's shoulder disslocation?

[Francine_Litz]

subluxation = partial dislocation (not completely out of socket)

dislocation = displacement of one or more bones at a joint

[jennyb]

I would think there would be a connection between length of time b4 dislocation was sorted out (reduced is the term innit??) and severity of lesion-the injuries from poor positioning on operation table are worse from longer surgery, so the length of time the nerve is compressed (as it presumably would be in a dislocation?) would affect the severity I guess. I know also that if the dislocation is dealt with wrong that can cause a tbpi too. I'll keep searching for info on this......

[Suzie]

Thanks for your replies, Susan, Francine, and Jenb!
From the xrays that I saw and the radiology reports--and the shape of David's shoulder anatomy when I got to him in the ER, a total dislocation is what he had-the shoulder is a ball and socket joint, and the ball--the head of his upper arm bone--the humerus-was completely out of socket for at least 3 1\2 hours from the medical records I have gathered--a sublux is where something is twisted and out of place, is the best way I can put it from my understanding---Does that make sense?? The difference from Susan's injury and Davids's is that David did not avulse any nerves away from the spinal column, where I think you did, right Susan? His nerves were more affected anteriorly to the shoulder I think? Anywho, bottom line is that I really think he was mismanaged in the ER, and that is why his injury was as sever as it is.......it stinks and as you all know -life altering--and we are luckier than most.....Hope all is going well with each of you--you continue to be in our thoughts and prayers--
~~~~Suzie~~~~

[admin]

sir
i am a player from the last two years i am suffering from disslocation problem . the shoulders disslocates at any time automaticaly & also locates after 1 min its own .my sports courier seems to be finish . orthopadic surgeon consult me to go for a operation . plz suggest me any treatment other than operation . i will be very thank full to u

waiting for ur reply nitin tyagi

[admin]

MY SON ALSO HAD MULTIDIRECTIONAL SHOULDER INSTABILITY AND IT WOULD DISLOCATED FROM EVERY DIRECTION. HE HAS HAD 2 SURGERIES. THE MOST RECENT SURGERY WE WENT TO THE ONE OF THE TOP SHOULDER SPECIALISTS EVEN THOUGH IT MEANT TRAVELING, AND SO FAR HIS DISLOCATION PROBLEM HAS NOT RETURNED, HE WAS (PRIOR TO SURGERY) LIKE YOU HE WOULD BE WALKING OR SLEEPING AND WOULD DISLOCATE. UNFORTUNATELY AND FORTUNATELY SHOULDER PROBLEM SEEMS TO BE FIXED. BUT HE STILL HAS BOUTS OF SEVERE PAIN, BOUTS OF WINGING AND SUDDEN ONSET OF ELBOW PAIN, AND AT TIMES HAS TROUBLE MOVING HIS FINGERS. HE ALSO HAS BURNING PAIN, WITH COLOR CHANGES. WE HAVE ACCEPTED THIS IS HIS LIFE AND HE MAKES THE MOST OUT OF HIS GOOD DAYS.