scholarly journals POSTTRAUMATIC SHOULDER INSTABILITY IN CHILDREN: CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT

2014 ◽  
Vol 2 (3) ◽  
pp. 47-52
Author(s):  
Yaroslav Nikolaevich Proshchenko ◽  
Pavel Sergeevich Shumkov ◽  
Anatoliy Vasilievich Ovsyankin ◽  
Pavel Igorevich Bortulev ◽  
Alexey Polikarpovich Drozdetskiy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Shoulder Instability ◽  
Humeral Head ◽  
Shoulder Dislocation ◽  
Clinical Presentation ◽  
Chronic Instability ◽  
Unsatisfactory Result ◽  
Traumatic Dislocation ◽  
Chronic Shoulder Instability ◽  
Type 3

The article presents an analysis of the treatment of 15 patients with posttraumatic shoulder instability aged 11-17 years, as a result of primary traumatic dislocation and chronic instability. We identified the following causes of chronic shoulder instability: Bankart injury, SLAP-injury; Hill-Sachs defect; fracture of the glenoid, type 3 humeral head-glenoid relation, and retroversion of the humeral head, as well as defects in the treatment of primary shoulder dislocation. Surgical treatment is performed in 7 patients with chronic instability (7 joints). Unsatisfactory result was detected in 1 patient (1 joints), which is caused by a type 3 humeral head-glenoid relation.

scholarly journals Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis

2018 ◽  
Vol 52 (23) ◽  
pp. 1498-1506 ◽  
Author(s):  
Lauri Kavaja ◽  
Tuomas Lähdeoja ◽  
Antti Malmivaara ◽  
Mika Paavola
Keyword(s):  
Systematic Review ◽  
Surgical Management ◽  
Shoulder Instability ◽  
Shoulder Dislocation ◽  
Meta Analysis ◽  
Ovid Medline ◽  
Chronic Shoulder Instability ◽  
Post Traumatic ◽  
First Time ◽  
Quality Evidence

ObjectiveTo review and compare treatments (1) after primary traumatic shoulder dislocation aimed at minimising the risk of chronic shoulder instability and (2) for chronic post-traumatic shoulder instability.DesignIntervention systematic review with random effects network meta-analysis and direct comparison meta-analyses.Data sourcesElectronic databases (Ovid MEDLINE, Cochrane Clinical Trials Register, Cochrane Database of Systematic Reviews, Embase, Scopus, CINAHL, Ovid MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily, DARE, HTA, NHSEED, Web of Science) and reference lists were searched from inception to 15 January 2018.Eligibility criteria for selecting studiesRandomised trials comparing any interventions either after a first-time, traumatic shoulder dislocation or chronic post-traumatic shoulder instability, with a shoulder instability, function or quality of life outcome.ResultsTwenty-two randomised controlled trials were included. There was moderate quality evidence suggesting that labrum repair reduced the risk of future shoulder dislocation (relative risk 0.15; 95% CI 0.03 to 0.8, p=0.026), and that with non-surgical management 47% of patients did not experience shoulder redislocation. Very low to low-quality evidence suggested no benefit of immobilisation in external rotation versus internal rotation. There was low-quality evidence that an open procedure was superior to arthroscopic surgery for preventing shoulder redislocations.ConclusionsThere was moderate-quality evidence that half of the patients managed with physiotherapy after a first-time traumatic shoulder dislocation did not experience recurrent shoulder dislocations. If chronic instability develops, surgery could be considered. There was no evidence regarding the effectiveness of surgical management for post-traumatic chronic shoulder instability.

scholarly journals Controversies in the Management of the First Time Shoulder Dislocation

2017 ◽  
Vol 11 (1) ◽  
pp. 1001-1010 ◽  
Author(s):  
José Luis Avila Lafuente ◽  
Santos Moros Marco ◽  
José Manuel García Pequerul
Keyword(s):  
Surgical Treatment ◽  
Shoulder Instability ◽  
Shoulder Dislocation ◽  
Glenohumeral Joint ◽  
Traditional Approach ◽  
High Rate ◽  
First Episode ◽  
Scientific Publications ◽  
Shoulder Range Of Motion ◽  
First Time

Background:Traditionally, initial management of first anterior shoulder dislocations consists of reduction of the glenohumeral joint followed by a period of immobilization and subsequent physical therapy to recover shoulder range of motion and strength. This traditional approach in management is now controversial due to the high rate of recurrence. The aim of this paper is to review and discuss the literature about the global management of patients presenting with first-time traumatic anterior glenohumeral dislocation, analyzing the factors that affect shoulder instability after the first episode of dislocation.Methods:Scientific publications about the management of first-time shoulder dislocations are reviewed. Pubmed is used for that and no limit in the year of publication are stablished. These papers and their conclusions are discussed.Results:Younger patients, patient´s activities and the kind of injury are the most important factors related to the shoulder instability after a first time traumatic dislocation. Authors that recommend surgical treatment after the first episode of dislocation argue that the possibilities of recurrence are high and therefore surgery should be performed before its occurrence. Other authors, however, argue that surgical treatment is demanding, and keep in mind that complications, such as recurrence, stiffness and pain after surgery, are still present.Conclusion:Currently, there is still no consensus in the literature with regard to the management of first episode of shoulder dislocation. It is necessary to analyze carefully every individual case to manage them more or less aggressive to obtain the best result in our practice.

scholarly journals Clinical forms of shoulder instability in pediatric patients

2016 ◽  
Vol 4 (4) ◽  
pp. 41-46
Author(s):  
Yaroslav N. Proshchenko ◽  
Alexei G. Baindurashvili ◽  
Ananstasiya I. Brianskaia ◽  
Evgeny V. Prokopovich ◽  
Maksim S. Nikitin ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
Joint Instability ◽  
Pediatric Patients ◽  
Recurrent Dislocation ◽  
Study Cohort ◽  
Clinical Forms ◽  
Chronic Shoulder Instability ◽  
Recurrent Shoulder Dislocation

Background. The recurrence rate of adolescent chronic shoulder instability is approximately 56%–68%. However, this pathology is often missed in childhood and adolescence.Aim. To identify the clinical forms of shoulder joint instability in pediatric patients.Materials and methods. The authors present the data from 57 pediatric patients aged 3−17 years with a total of 61 unstable shoulder joints. All patients were divided into groups according to the form of instability. Traumatic chronic shoulder instability was identified in 40 patients (Bankart and Hill–Sachs injuries). Of these, non-traumatic shoulder instability was diagnose in 17, including five with recurrent dislocation, and spontaneous shoulder dislocation due to dysplasia of glenoid and labrum was diagnosed in 12. Of the 57 patients in the study cohort, 53 underwent surgery. Postoperatively, two patients developed recurrent shoulder dislocation (Andreev–Boichev technique) due type III shoulder dysplasia in the first patient and multidirectional injury in the second.Conclusions. Shoulder joint instability should be considered as the traumatic or non-traumatic form. Treatment decisions should be based on anatomical characteristics that predispose to recurrent dislocation.

The Clinical Presentation of Shoulder Instability Including on Field Management

1995 ◽  
Vol 14 (4) ◽  
pp. 761-776 ◽  
Author(s):  
Roald Bahr ◽  
Edward V. Craig ◽  
Lars Engebretsen
Keyword(s):  
Shoulder Instability ◽  
Clinical Presentation ◽  
Field Management

scholarly journals The Shoulder Instability: An Overview

2021 ◽  
Author(s):  
Balaji Zacharia ◽  
Arun Prakas ◽  
Subramanian Vaidyanathan ◽  
Antony Roy ◽  
Mohammed Komalam Ayyub
Keyword(s):  
Natural History ◽  
Shoulder Instability ◽  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
Narrative Review ◽  
Pathological Anatomy ◽  
Dynamic Factors ◽  
History Of ◽  
Classification And Treatment

AbstractInstability of the shoulder joint is common but most of the time it is unrecognized by the treating surgeon. The symptoms can vary from subtle pain to shoulder dislocation. In many cases, there is no history of trauma. The shoulder joint is stabilized by both static and dynamic factors, and treatment is complex, with recurrence more common in young athletic individuals. Open and arthroscopic techniques of stabilization are available with specific indications for each of these methods. In this narrative review of shoulder instability, we describe the pathological anatomy, evaluation, natural history, classification, and treatment of shoulder instability.

scholarly journals MEAN 6 YEAR CLINICAL OUTCOMES, SURVIVORSHIP, AND RETURN TO SPORTS AFTER ARTHROSCOPIC CAPSULAR REPAIR WITH SUTURE ANCHORS FOR ADOLESCENT MULTIDIRECTIONAL SHOULDER INSTABILITY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Alyssa Carrol ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Shoulder Instability ◽  
Surgical Intervention ◽  
Operation Time ◽  
Demographic Variables ◽  
Return To Sports ◽  
Suture Anchors ◽  
Surgical Failure

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]

Sign in / Sign up

Export Citation Format

Share Document