Primary anterior shoulder dislocation and rotator cuff tears

1999 ◽  
Vol 8 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Roger Berbig ◽  
Dominik Weishaupt ◽  
Jürg Prim ◽  
Osama Shahin
2018 ◽  
Vol 6 (6) ◽  
pp. 232596711878131
Author(s):  
Madis Rahu ◽  
Jüri-Toomas Kartus ◽  
Elle Põldoja ◽  
Kirsti Pedak ◽  
Ivo Kolts ◽  
...  

Background: Because of the high risk for redislocations after a first-time traumatic anterior shoulder dislocation with conservative treatment, recent publications have recommended early arthroscopic intervention, especially for young athletes. Concomitant rotator cuff tendon damage may occur when the shoulder dislocates; however, its presence and influence on clinical results have not been well described in this patient category. Hypothesis: In opposition to current opinion, a substantial number of articular-sided partial-thickness rotator cuff tears (APTRCTs) would be found at surgery after a first-time traumatic anterior shoulder dislocation in young athletes. However, the impact of these injuries on 2-year postoperative results would be negligible. Study Design: Cohort study; Level of evidence, 3. Methods: Sixteen male patients (mean age, 21 years [range, 16-25 years]) with a first-time traumatic anterior shoulder dislocation without bony Bankart lesions were included in this study. The indications for surgical treatment were age less than 25 years and being active in collision or contact sports at a competitive level. Arthroscopic surgery was performed at a mean 7.8 days (range, 2-14 days) after injury. Rowe and American Shoulder and Elbow Surgeons (ASES) scores as well as range of motion were evaluated at a minimum 2 years after an arthroscopic Bankart procedure, and a comparison of the clinical results between patients with and without APTRCTs was conducted. Results: An anterior-inferior capsulolabral injury was found in all patients. There were no bony Bankart lesions. An APTRCT was found in 9 of the 16 patients. At 2 years after surgical treatment, there were no significant differences between the patients with and without APTRCTs in terms of the Rowe score (90.0 and 87.1, respectively; P = .69) and ASES score (94.6 and 90.4, respectively; P = .67). Conclusion: APTRCTs were found in the superior part of the shoulder joint after a first-time traumatic anterior shoulder dislocation in a majority of young male athletes treated with surgical stabilization. There were no significant differences found between patients with and without APTRCTs in terms of the Rowe and ASES scores at 2 years after surgical treatment.


2004 ◽  
Vol 7 (2) ◽  
pp. 98-102
Author(s):  
Do-Yung Kim ◽  
Hyun-Chul Park ◽  
Yong-Wook Park ◽  
Sang-Soo Lee ◽  
Dong-Hyun Suh ◽  
...  

Author(s):  
German Alejandro Jaramillo Quiceno ◽  
Sergio Andres Arroyave Rivera ◽  
Margarita Maria Ortiz

Acute massive rotator cuff tears and posterior shoulder dislocations are an extremely rare association, and a vast majority are treated by open surgery. We present a case of a man in his 20s who suffered closed left shoulder trauma after a road traffic accident. He was initially diagnosed with posterior shoulder dislocation and a reduction was successfully performed. However, the patient still complained of persistent weakness during active movements. We found a massive rotator cuff tear involving all the rotator cuff tendons, with significant supraspinatus retraction and persistent posterior shoulder subluxation. He underwent an all-arthroscopic repair of the rotator cuff with a double-row technique in the subscapularis, supraspinatus and infraspinatus muscles. Capsular repair and tenodesis of the biceps tendon were also performed. The patient had good recovery, reaching full preinjury function 3 months after surgery with a successful return to his regular activities.


2020 ◽  
pp. 175857322091328
Author(s):  
R Zhou ◽  
G Prasad ◽  
S Robinson ◽  
S Shahane ◽  
A Sinha

Background The highlight of the British Elbow and Shoulder Society pathway for the management of traumatic anterior shoulder instability is early imaging in patients aged over 40 years to assess rotator cuff integrity and early repair, if indicated to optimise function. The senior author set up a protocol in our institute to streamline the diagnostic process for this cohort of patients. This was a retrospective analysis from a prospectively collected database to highlight the importance of early specialist imaging. Methods Our protocol is to perform urgent ultrasound scans for all suitable patients above 40 years after first-time traumatic shoulder dislocation. Demographics, associated injuries, ultrasound scan results, operations and functional outcomes were collated. Results One year following the introduction of our protocol, 40 patients with a mean age of 67 (range, 42–89; SD = 13.1) had ultrasound. The incidence of full-thickness rotator cuff tears was 57.5% (n = 23). Eleven patients with confirmed full-thickness rotator cuff tears underwent surgery. The mean age of surgical patients was significantly younger than the non-surgical group (p = 0.004). Discussion The use of early diagnostic imaging demonstrated a high incidence of full-thickness rotator cuff tears in this cohort of patients. This allowed early surgical repair to optimise function.


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