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At least 91 records · Page 5Linked to original sources
PubMed1988

Reduction of shoulder dislocations under interscalene brachial blockade.

Even under short sedation, reduction of shoulder dislocations is often difficult, because of the reflectory contraction of the muscles around the humeroglenoidal joint in response to pain. Administration of interscalene brachial blockade produces analgesia and complete relaxation of the muscles of the shoulder joint. We report on ten consecutive shoulder dislocations which were reduced while the patients were under interscalene brachial blockade. In all cases, reduction was easy and free from complications.

Adolescent↗
PubMed1984

[Experiences with Weber's subcapital rotation osteotomy in recurrent shoulder dislocation].

In 23 patients suffering from recurrent posttraumatic dislocation of the shoulder joint the derotation of the humeral head was performed as described by Weber. A description of the operative technique is given. As recommended by Weber an angled 1/2-tubular plate with 7 holes was used for stable osteosynthesis 17 times. After movement treatment removal of the osteo-synthesis-material was possible 6 to 8 months later. Because of high absence of recidivity with repair of full mobility and full strength the derotation of the humeral head is a treatment of choice in cases of recurrent posttraumatic dislocation of the shoulder joint.

Adolescent↗
PubMed1989

The epidemiology of shoulder dislocations.

In an urban population of a quarter of a million, all shoulder dislocations that occurred in a 5-year period were recorded. A total of 216 shoulder dislocations were seen, 53.3% in men. The overall incidence rate was 17/100,000 per year. Incidence peaks were found in the age-group 21-30 years among men and in the age-group 61-80 years among women. Significantly more patients in the older age groups, and especially women, dislocated at home by falling on an outstretched arm, whereas the younger age-groups most frequently dislocated outside the home, e.g., on sports fields. A considerable number of patients (18.6%) were hospitalized, and 85.5% of the patients required outpatient follow-up. Prophylactic measures should be taken especially to increase the safety of the elderly in their homes.

Accidental Falls↗
PubMed1979

External rotation method of shoulder dislocation reduction.

We used the external rotation method for reducing anterior shoulder dislocations on 85 consecutive patients seen in our emergency department during a one-year period. In relatively inexperienced hands, the external rotation method was successful on first attempt in 80% of cases. There were no complications attributable to the technique itself. We feel that it is a successful, easy, and atraumatic method of achieving reduction in both first occurrence and recurrent anterior shoulder dislocations.

Adolescent↗
PubMedDate not supplied

Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases.

The purpose of our study was to evaluate the use of static magnetic resonance imaging (MRI) as a preoperative diagnostic tool in young patients with a traumatic primary anterior shoulder dislocation. Twenty-five patients who had acute primary traumatic anterior shoulder dislocation were examined with MRI and arthroscopy. The patients (18 male and 7 female) were between 16 and 39 years old (mean age, 27 years). They had no previous shoulder dislocations. The dislocations were confirmed radiographically. Examination with MRI and arthroscopy was performed within 10 days after the trauma. The MRI evaluation was performed before the arthroscopic examination, and the images were interpreted by an experienced magnetic resonance radiologist. No information from the MRI examination was available to the orthopedic surgeons before arthroscopy. The standard of reference for comparison was arthroscopy. Subacute MRI evaluation identified 15 labral tears, 12 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial joint side rotator cuff lesion, and 1 partial rupture of the biceps tendon. Arthroscopic examination revealed 22 labral tears, 15 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial joint side rotator cuff tear, 1 partial rupture of the biceps tendon, and 1 osseous Bankart lesion. Anterior capsulolabral tears and Hill-Sachs lesions appeared with a high incidence after acute anterior primary shoulder dislocation. Conventional MRI was only moderately reliable in the preoperative evaluation of labral tears and Hill-Sachs lesions, and it failed to give an accurate, differentiated preoperative diagnosis of the capsulolabral lesions.

Adolescent↗
PubMed1984

New traction devices to aid reduction of shoulder dislocations.

A set of traction devices that aid in the reduction of shoulder dislocations is described and their use and efficiency are discussed. A series of 47 consecutive patients seen over a six-month period and diagnosed as having shoulder dislocations with no other major trauma composed the study population. After radiographic confirmation and premedication with analgesics and muscle relaxants, the devices were used. The traction- countertraction method was used initially. When this method was unsuccessful, the Stimson method was performed using an alternate traction strap. These devices were successful in 96% of the relocations attempted. No complications were encountered. The traction devices were found to be effective and easy to use.

Adolescent↗
PubMedDate not supplied

Intraarticular lidocaine versus intravenous analgesic for reduction of acute anterior shoulder dislocations. A prospective randomized study.

We performed a prospective, randomized study to evaluate the use of injected lidocaine as an anesthetic for closed reduction of acute anterior shoulder dislocations. Thirty consecutive patients who presented at the emergency department with acute anterior shoulder dislocations were randomly placed in one of two groups. One group received an intraarticular injection of 20 ml of 1% lidocaine and the other group, intravenous injections of morphine sulfate and midazolam. The groups were compared regarding time of reduction maneuver, difficulty of reduction, subjective pain, complications, and total time spent in the emergency department. The lidocaine provided adequate anesthesia and secondary relief of muscle spasm in 15 of 15 (100%) patients. When compared with the intravenous sedation group, the lidocaine group showed no statistically significant difference in time for reduction maneuver, difficulty of reduction, or subjective pain. The lidocaine group had no complications and had a statistically significant shorter emergency department visit when compared with the intravenous sedation group (mean, 78 minutes versus 186 minutes; P = 0.004). Lidocaine provides excellent anesthesia for patients with uncomplicated anterior shoulder dislocations and can be very beneficial when sedation is contraindicated. Lidocaine injections also proved to be cost effective in our institution, reducing total costs by as much as 62%.

Acute Disease↗
PubMed1995

[Differential therapy of traumatically-induced persistent posterior shoulder dislocation. Review of the literature].

Three-hundred and twenty-nine cases of posterior dislocation of the shoulder documented in 300 articles published in the international literature are reviewed. They included 130 cases in which the duration of the dislocation was longer than 6 weeks and the dislocation could be classified as persistent primary dislocation. This group is the second largest group following that with acute primary dislocation. The mechanism of injury may be direct or indirect force: trauma, convulsions or electrocution are usually responsible for this type of dislocation, which often persists for longer than 6 weeks. Anatomically, 97.5% of dislocations are classified as subacromial. Posterior dislocation of the shoulder is commonly misdiagnosed on plain antero-posterior radiographs, and in over 50% of cases the diagnosis was missed on first examination. The typical signs of primary traumatic posterior dislocation of the shoulder are described. Management of persistent traumatic posterior dislocation of the shoulder depends on the size of the anterior Hill-Sachs lesion, the precipitating mechanism and the duration of dislocation. The results of 109 surgically and 24 conservatively treated dislocations of this type that have been published in the international literature are reviewed. Closed reduction is indicated in carefully selected cases with an anterior Hill-Sachs lesion under 15% of the size of humeral head (measured in the axillary view) that has been dislocation for less than 2 months. In most due to convulsions there was a distinct anterior Hill-Sachs lesion, which led to recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroplasty↗
PubMed1985

[Diagnosis and therapy of traumatic posterior shoulder dislocations].

In cases of dislocation of the shoulder the humeral head almost always dislocates anteriorly. Only rarely does the dislocation result in a posterior position of all or part of the humeral head. The diagnosis of posterior dislocation is not always as easy as the diagnosis of anterior dislocation and for this reason the injury is often missed. Cisternino et al. found that over 50% of patients with posterior dislocation of the shoulder were missed on initial examination. The longer the time between accident and treatment, the more difficult that treatment becomes and the harder it is to achieve a satisfactory functional result. Therefore it is vital to think of this injury in all cases of severe contusion of the shoulder and if there is the slightest suspicion of this injury, the patient must be aggressively investigated to establish the relationship between the humeral head and the glenoid.

Bone Plates↗
PubMed1993

[Results of arthroscopic ventral limbus capsule refixation after primary traumatic shoulder dislocation].

The three-year results for arthroscopic refixation of the labrum-ligament-capsule complex after traumatic primary dislocation of the shoulder will be discussed. This prospective study included only patients with primary dislocations showing radiographic signs of anterior instability in the drawer test and no accompanying bony injuries. Twenty-six patients with an average age of 31 years and arthroscopic suture had been dismissed from postoperative treatment after an average 15 weeks showing a fully mobile and pain-free shoulder joint. At the time of follow-up the average results obtained with our own score were 94.1 points. 61.5% of the patients showed fully mobile shoulder joints and 84.6% reported full sporting capacity. Negative findings were obtained for all stability tests performed after 32 months. No recurrencies had occurred until the time of the follow-up. Compared to the reluxation rates described in the literature for traumatic primary shoulder dislocations in juvenile patients, our three-year results were highly positive and we will continue to use arthroscopy in the treatment of instable shoulder joints after traumatic primary dislocation in order to avoid recurrencies and associated sequelae.

Adult↗
PubMed1990

Prognosis of primary anterior shoulder dislocation in young adults.

From 1982 to 1987, 194 patients with 196 primary traumatic anterior shoulder dislocations were treated in our hospital. One hundred and sixty-six patients with 168 shoulder dislocations (87%) were available for study at follow-up an average of 4 years after treatment. The most important prognostic factor in relation to recurrence was the age of the patient at the time of the primary dislocation. The highest recurrence rate was found in patients of 30 years and younger (64%). Athletes in this age group had no worse a prognosis as to recurrence than non-athletes. A fracture of the greater tuberosity improved the prognosis significantly (P less than 0.01). Neither the presence of a Hill-Sachs lesion nor the period of immobilization influenced the recurrence rate in patients aged 30 years and younger.

Adolescent↗