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At least 19 recordsLinked to original sources

A review of the Bristow operation for recurrent anterior shoulder dislocation in athletes.

Twenty-four recurrent dislocating shoulders, in patients ranging from 15 to 26 years, were evaluated after surgical treatment using the Bristow procedure. The operative procedure is discussed in detail recommending the use of an A-O malleolar compression screw, because of ease in insertion, to fix the caroacoid process to the anterior scapular neck. The Bristow procedure as described is an effective operation for achieving shoulder stability while maintaining nearly a complete range of motion in most cases. There was one case of recurrent dislocation after surgery which is described in detail. Six of 24 shoulders demonstrated some loss of external rotation, with the maximum being only 10 degrees. Five of 9 patients had some difficulty in throwing when the dominant extremity was treated. This did not appear to be related to any possible decrease in external rotation.

Adolescent

Arthrography in acute shoulder dislocations.

Arthrography of the shoulder was performed on 50 patients with acute traumatic shoulder dislocations. The mean interval between injury and arthrogram was 2.3 days, with a median interval of one day. Anterior dislocations occurred in 96% of patients, and posterior dislocations in 4%. Initial dislocations were present in 74%, and recurrent dislocations in 26%. The most frequent abnormality identified or arthrograms was an enlarged but intact shoulder capsule (58%), most commonly seen in shoulders subject to recurrent dislocations (77%). Shoulder joint capsular tears or disruptions were seen in 48% of the patients. The next most common lesion was fracture (52%), identified on standard roentgenograms. These included Hill-Sachs lesions (28%), greater tuberosity fractures (22%), and coracoid fractures (2%). Ruptures of the rotator cuff, present in 28% of the cases (14 patients), occurred more frequently in initial dislocations (62%) than in recurrent ones (36%). The high frequency of enlarged intact shoulder capsules, even after an acute initial joint dislocation (58%), suggests that the humeral head does not routinely rupture the capsule during dislocation, but rather tears the glenoid labrum at its bony attachment and dislocates subperiosteally, dissecting a false pouch below the periosteum and under the subscapularis.

Acute Disease

[Has the duration of cast fixation after shoulder dislocations an influence on the frequency of recurrent dislocation? (author's transl)].

102 primary shoulder dislocations have been evaluated. Some were retained in a Velpeau bandage reinforced with plaster immediately after reposition for three weeks, others were treated with a sling or tube gauze only. The frequency of recurrent dislocation in both groups was compared. It could be demonstrated that the results were equal for both groups. We conclude that fixation with Velpeau Sling and cast reinforcement does not significantly influence the occurrence of recurrent dislocations.

Adolescent

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

The trough line: a radiographic sign of posterior shoulder dislocation.

Over 50% of posterior dislocations of the shoulder are not recognized initially because of failure to appreciate the subtle clues available on the standard frontal projection. In 15 of 20 cases of posterior dislocation, two parallel lines of cortical bone were identified on the medial aspect of the humeral head. One line represents the medial cortex of the humeral head. The other was found to represent the margin of a troughlike impaction fracture. This is designated the "trough line". This line proved to be an important clue in the recognition of posterior dislocations of the shoulder.

Adult

Early complications of primary shoulder dislocations.

A prospective study of the complications of primary shoulder dislocation was carried out for the 3-year period 1973-1976. The clinical examination was made initially in the Casualty Department and the patient was re-examined in the Department of Physical Medicine. In the evaluation special attention was given to the condition of the rotator cuff, the blood vessels and the motor and sensory function of the affected extremity. Sixty-three out of 238 patients (26 per cent) presented with the following complications: 29 lesions of the brachial plexus, 21 of the axillary nerve and 28 ruptures of the rotator cuff tendon. Complications occurred more frequently in the age group over 50 years (P less than 0.001) and in manual labourers compared with office workers (P less than 0.05). If the humerus remained unreduced for more than 12 hours, the frequency of complications increased (P less than 0.01).

Adolescent

Posterior shoulder dislocation with ipsilateral humeral shaft fracture. A case report.

A 41-year-old man incurred the unusual combination of subacromial posterior dislocation of the shoulder and ipsilateral humeral shaft fracture. The importance of inspection of joints proximal to long bone fractures cannot be overemphasized. The transscapular view is easily adapted to the diagnosis of this injury. When recognized early, closed reduction is the preferred treatment; open reduction, as in the present case, is reserved for chronic dislocation.

Adult

Shoulder dislocation in Swedish ice hockey players.

1. Humeroscapular dislocation, primary or recurrent, is found in 8% of elite ice hockey players in Sweden. 2. The dislocation recurs in 90% of greater than 20-year-old players and the frequency diminishes with increasing age. 3. The duration of immobilization after the first dislocation bears no sure relation to the risk of recurrence. 4. In 80% of the cases, the operated shoulder was the one that predominates in ice hockey, usually the left. Of the 32 operated players, 30 have been able to continue with ice hockey and relatively marked postoperative loss of mobility has been tolerated well. 5. Even without an operation, a recurrent shoulder dislocation did not prevent one-third of the players from continuing with ice hockey.

Adult