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At least 163 records · Page 9Linked to original sources
PubMed1998

Early arthroscopic treatment of primary traumatic anterior shoulder dislocation. A follow-up study.

This study evaluates the results of early arthroscopic Bankart repair in patients with primary traumatic anterior dislocation of the shoulder. The patients' age range was 17-34 years. Arthroscopic Bankart repair was performed within 12 days after the dislocation. First follow-up was at 18 months. According to Rowe's score, 11 patients (73%) were excellent, 3 (20%) were good and 1 (7%) was poor. The median external rotation deficit was 4 degrees in the adducted position. At a second follow-up at 34 months, two patients had redislocated. Both of these patients had severe generalized joint laxity. Another patient reported frequent subluxations. We conclude that in young patients with primary anterior traumatic shoulder dislocation, early arthroscopic Bankart repair implies a low recurrence rate and restores shoulder function to normal. Generalized joint laxity could indicate an increased risk for recurrent dislocation.

Adolescent↗
PubMed1995

Arthroscopic bioabsorbable tack stabilization of initial anterior shoulder dislocations: a preliminary report.

Twenty-six consecutive cadet athletes sustained an acute, initial anterior shoulder dislocation. All dislocations required a manual reduction for initial treatment. Arthroscopy was performed within 10 days in all patients. The Beach chair position and interscalene anesthesia were used in each case. At arthroscopy, 25 patients had an avulsion of the anterior-inferior capsulolabral complex (Bankart lesion) from the glenoid rim. One patient had a lateral detachment of the inferior glenohumeral ligament from the humeral neck. Twenty-three patients had a Hill-Sachs lesion and 3 SLAP tears were noted. All Bankart lesions were repaired with a cannulated bioabsorbable fixation device. Nineteen patients, over 1 year postoperative, are the subject of this preliminary report. The average age was 19.5 years (range, 17 to 23 years). Follow-up averaged 19 months (range, 12 to 24 months). The average loss of external rotation was 3 degrees. There have been no recurrent dislocations and 1 patient has had a single episode of resubluxation. Using the Rowe point score, 16 patients were rated excellent, 2 good, and 1 fair. All of the athletes in this study have returned to preinjury performance status. Acute stabilization of initial anterior shoulder dislocations appears to be an effective treatment option in young athletes known to have high recurrence rates with nonoperative treatment. This particular technique has been safe with little morbidity.

Absorption↗
PubMed1991

[Therapeutic procedure in initial traumatic shoulder dislocation (arthroscopy--limbus refixation)].

This is a report of the therapeutic measures following primary traumatic dislocation of the shoulder in young patients (under 40 years of age). In order to rule out a disruption of the glenoid labrum, all patients were subjected to arthroscopy and disruption thus diagnosed in 38 of 48 cases. Surgical refixation of the glenoid labrum was performed on these patients. The ten patients with a stable labrum were given a Gilchrist dressing, immobilizing the shoulder for two to three weeks. Eight of the ten patients who had only had arthroscopy were followed up for an average of three years (two to six years). One developed recurrent dislocation of the shoulder. 31 of 38 patients who had had surgical refixation of the glenoid labrum were followed up for an average of 2.4 years (two to 5.8 years). None of these patients developed recurrent dislocation. Clinically, 25 patients have no pain whatsoever, while five report minor complaints, 30 patients are satisfied with the surgical outcome and only one is not.

Adolescent↗
PubMed1993

Stability in relation to humeral head retroversion after surgical treatment of recurrent anterior shoulder dislocations.

This study reports the influence of the retroversion angle on the postoperative stability in 50 patients operated on for recurrent shoulder dislocations. Fifty-two shoulders were reviewed by radiographic and clinical examinations. Particular attention was focused on humeral head retroversion, shoulder stability, and range of motion in relation to surgical technique. The retroversion angle was significantly reduced in 30 of 47 shoulders, for which satisfactory radiographs could be achieved. Mean humeral head retroversion was 24 degrees for both dominant and nondominant shoulders. Forty-eight of 52 reexamined shoulders became stable. Four had remaining instability following a Putti-Platt procedure, with a mean retroversion angle of 18 degrees. A reduced humeral head retroversion is therefore proposed as an important factor in creating instability, and may be one explanation for failed stability after soft tissue repair. Irrespective of the type of surgical procedure (Bristow or Putti-Platt), there was a significant decrease in range of shoulder rotation in the operated shoulder compared to the contralateral stable shoulder and to reference values for normal controls. However, decreased rotation was not found to impair shoulder function, and 48 of the 50 reexamined patients generally improved after surgery.

Adolescent↗
PubMedDate not supplied

The microscopic pathoanatomy of acute anterior shoulder dislocations in a simian model.

PURPOSE: The purpose of this study was to determine the extent of capsular injury that occurs at a microscopic level in association with acute anterior shoulder dislocations. TYPE OF STUDY: The study was an anatomic, cadaveric study using a simian model. The microscopic slide review was blinded regarding the presence or absence of dislocation. METHODS: Three cadaveric monkey shoulder specimens were dissected free of muscle tissue but left undislocated as controls. Eleven cadaveric monkey shoulder specimens were dislocated with an abduction and external rotation force and subsequently evaluated grossly and histologically for the presence and direction of gross and microscopic injury. RESULTS: All dislocated specimens had an associated Bankart lesion. In addition, all dislocated specimens had histologic evidence of capsular microtearing. The tears were in no specific location or direction and were at times located perpendicular to, obliquely to, or between the longitudinal orientation of the fibers. CONCLUSIONS: Based on this model, a Bankart lesion is a common and usual occurrence with acute anterior shoulder dislocations. In these specimens, the Bankart lesion was never an isolated pathology. Microscopic capsular injury was always associated. Additionally, the direction of the capsular injury is highly variable.

Animals↗
PubMedDate not supplied

Primary anterior shoulder dislocation and rotator cuff tears.

In a prospective controlled study 167 patients with 167 primary traumatic anterior shoulder dislocations underwent early ultrasonograpic evaluation for rotator cuff tears. We found 53 (31.7%) full-thickness cuff tears in this group. Compared with a group of 93 healthy volunteers, we found with statistical significance more cuff tears in the patients aged < 60 years. Women ruptured the cuff more often than men. If the patient is not able to elevate the affected arm more than 90 degrees in the scapular plane 2 weeks after the dislocation, there should be a high suspicion of rotator cuff tear (76.7%). For early detection of relevant rotator cuff lesions, we recommend shoulder ultrasonographic examination and measurement of active elevation after each traumatic shoulder dislocation in the above mentioned age group.

Adolescent↗