Types of Glenohumeral Instability.

Last updated Thursday, February 10, 2005

Degree of instability

What are glenohumeral dislocations, subluxations, and apprehensions?

Recurrent instability may be characterized as dislocation, subluxation or apprehension.

Dislocation of the glenohumeral joint is the complete separation of the articular surfaces; immediate, spontaneous relocation may not occur. Glenohumeral subluxation is defined as symptomatic translation of the humeral head on the glenoid without complete separation of the articular surfaces. Subluxation of the glenohumeral joint is usually transient: the humeral head returning spontaneously to its normal position in the glenoid fossa. In a series of patients with anterior shoulder subluxation reported by Rowe and Zarins, (Rowe and Zarins, 1981) 87 per cent were traumatic and over 50 per cent were not aware that their shoulders were unstable. Like dislocations, subluxations may be traumatic or atraumatic, anterior, posterior, or inferior, acute or recurrent, or they may occur after previous surgical repairs that did not achieve complete shoulder stability. Recurrent subluxations may coexist with or be initiated by glenohumeral dislocation. Rowe and Zarins (Rowe, 1956; Rowe and Zarins, 1982) reported seeing a Hill-Sachs compression fracture in 40 per cent of the patients in their series on subluxation of the shoulder, an observation indicating that at some time these shoulders had been completely dislocated. Apprehension refers to the fear that the shoulder will subluxate or dislocate. This fear may prevent the individual from participating fully in work or sports.

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