Mid-term results of arthroscopic Bankart repair and remplissage for recurrent anterior shoulder instability in patients with a history of seizures

Background Seizure predisposes patients to shoulder dislocation. However, there is no consensus regarding the best management approach for recurrent shoulder dislocation in patients who have a history of seizures. In this study, we report the outcome of arthroscopic Bankart repair augmented by Remplissage for the recurrent anterior shoulder dislocation in a series of patients with a history of seizures. Methods In this retrospective study, 27 patients with 29 recurrent anterior shoulder dislocations who were treated with the arthroscopic Bankart repair were included. All cases had deep Hill-Sachs lesions according to Hardy classification that was managed with a Remplissage technique. Patients with a glenoid defect of more than 20% in the CT scan were excluded. Twenty-two patients had an epileptic seizure, while the remaining five patients had convulsions due to other causes. The mean age of the patients was 28.3 ± 6.2 years. The mean follow-up of the patients was 3.1 ± 1.2 years. Outcome measures included the shoulder range of motion that was compared with the non-injured side in the unilateral subjects and the shoulder function that was evaluated by the Rowe score and the Walch-Duplay score. Results The mean forward flexion, abduction, external rotation, and internal rotation were not significantly different between injured and non-injured shoulder (p = 0.34, p = 0.41, p = 0.11, p = 0.23). The mean Rowe score was 49.1 ± 7.8 before the surgery and 92.1 ± 6.4 at the last visit (p < 0.001). According to the Walch-Duplay score, the shoulders were categorized as excellent, good, and fair in 17 (58.7%), 11 (37.9%), and 1 (3.4%) shoulder, respectively. The overall rate of instability recurrence was 17.2% (n = 5). Conclusion In patients with a history of seizures, arthroscopic Bankart repair augmented by Remplissage could be regarded as a safe and efficient method for the treatment of recurrent anterior shoulder dislocation with glenoid defect < 20%.

A surge in neglected shoulder dislocations and delayed surgical management due to the coronavirus disease 2019 lockdown in India

Four patients with shoulder problems that were traumatic in etiology presented to us with delays in seeking care ranging from 6 to 12 weeks due to the coronavirus disease 2019 (COVID-19) lockdown. The care of three cases (a 3-month-old neglected anterior shoulder dislocation with a greater tuberosity fracture in a 30-year old man, a 3-month-old neglected anterior shoulder dislocation in a 17-year old boy, and a 2-month-old neglected greater tuberosity fracture in a 31-year old man) was delayed due to the lockdown and the ensuing travel restrictions, while that of one case (a 6-week-old fracture–dislocation of the proximal humerus in a 55-year-old woman) was delayed because the patient was undergoing treatment for COVID-19 at the time of injury. This report intends to present the exceptional circumstances around these cases. The unique treatment challenges and their outcomes are also described to advise the surgeons of the nuances and difficulties in treating these injuries.

Efektivitas Penggunaan Intervensi Fisioterapi Terapi Latihan dan Infrared Pada Kasus Dislokasi Sendi Bahu

Kegiatan dasar berupa gerak merupakan suatu kebutuhan dan tuntutan manusia terutama dalam era globalisasi seperti sekarang. Anggota gerak atas memiliki keterlibatan yang sangat tinggi dalam semua aktivitas yang dilakukan oleh manusia. Seluruh aktivitas yang dilakukan sehari-hari banyak bergantung terutama pada fungsi anggota gerak atas. Tangan dan lengan merupakan pemeran utama, sehingga apabila terjadi gangguan tertentu, hal tersebut akan mengganggu mobilitas dan kegiatan manusia. Sendi bahu merupakan salah satu sendi besar yang paling umum terjadi dislokasi, hal tersebut dapat terjadi karena rentang gerak sendi yang luas, dangkalnya fossa glenoid, dan ligament laxity pada beberapa orang. Dislokasi sendi bahu merupakan suatu kondisi dimana terjadi pergeseran caput humerus dari sendi glenohumeral, sehingga hal tersebut dapat menyebabkan kerusakan pada saraf serta dapat terjadi berulang. Jurnal ini bertujuan untuk menjelaskan efektivitas pemberian intervensi terapi latihan dan terapi infrared pada kasus dislokasi sendi bahu dan menambah pengetahuan pembaca mengenai kasus dislokasi sendi bahu. Metode penelitian yang digunakan yaitu deskriptif kualitatif dengan pengambilan materi berbasis literature review. Hasil penelitian menunjukkan bahwa pemberian terapi latihan dan terapi infrared efektif untuk menurunkan nyeri, meningkatkan kekuatan otot, meningkatkan lingkup gerak sendi (LGS), serta meningkatkan kemampuan fungsional pasien yang menderita kasus dislokasi sendi. Basic activities are in the form of a necessity and human need, especially in the era of globalization as it is now. Upper limbs have a very high involvement in all activities carried out by humans. Everything that is done daily, especially activities on the function of the upper limbs. Hands and arms are the main actors, so that if certain disturbances occur, it will interfere with mobility and human activities. The shoulder joint is one of the most commonly dislocated large joints, this can occur due to the wide range of motion of the joint, the shallowness of the glenoid fossa, and ligament laxity in some people. Dislocation of the shoulder joint is a condition in which the humeral head shifts from the glenohumeral joint, so that it can cause nerve damage and can occur repeatedly. This journal aims to explain the effectiveness of providing exercise therapy and infrared therapy in shoulder dislocation cases and the reader's knowledge about shoulder dislocation cases. The research method used is descriptive qualitative by taking material based on a literature review. The results showed that providing exercise therapy and infrared therapy to reduce pain, increase muscle strength, increase range of motion, and improve the ability of patients suffering from joint dislocation cases.

A rare case of bilateral antero-internal shoulder dislocation in a judo player: a case study and review of the literature

Pure anterior bilateral shoulder dislocations are rare clinical features, especially in traumatic forms. They are most often posterior, occurring during an epileptic seizure. Few cases are described in the literature, and the mechanism varies from case to case. We report a specific case of pure bilateral anterior shoulder dislocation in a 29-year-old judo player following an accident during his training and discuss the circumstances, mechanism, treatment, and prognosis.

History of closed reduction techniques and initial management for shoulder dislocations: From classical antiquity to modern times

This review gives a summary of the records of shoulder dislocation management throughout history until the point that anaesthetics were introduced and modern medicine improved dislocation management exponentially. A dislocation is a mechanical injury that has been managed in different ways throughout history. The shoulder reduction methods described in Hippocrates Corpus have been described and adjusted throughout history by later physicians. For example, in ancient Greek, Hippocrates considered the ambe, a device used to reduce the shoulder, to be the most powerful tool. However, Cooper, a physician in the 19th century, considered it to be the last resort due to substantial damage to the ribs and discomfort of the patient. This review demonstrates that there were many physicians that contributed to shoulder dislocation management. These physicians paved the way for modern shoulder dislocation treatment strategies.

Instability Severity Index Score Does Not Predict the Risk of Shoulder Dislocation after a First Episode Treated Conservatively

The first purpose of this study was to verify the association between Instability Severity Index Score (ISIS) and Recurrent Shoulder Dislocation (RSD) after a first episode treated conservatively. The second aim is to identify the risk factors associated with RSD after a primary acute shoulder anterior dislocation treated conservatively. A total of 111 patients with first traumatic anterior shoulder dislocation treated at a single trauma centre between January 2014 and March 2016 were enrolled. The main predictive variables of risk factors and the ISIS score were calculated. Among the 85 patients included, 26 cases of RSD were observed (30.6%). Considering the whole population, no significant association between ISIS and RSD were reported. Regarding other risk factors, high-risk working activities and rotator cuff injury had a significantly higher RSD risk. Sex, dominant limb, familiar history, hyperlaxity, contact or overhead sports, competitive sport, post-reduction physiokinesitherapy, return to sports activity time, Hill-Sachs lesion, bony Bankart lesion and great tuberosity fracture did not seem to influence the risk of RSD. No correlation between ISIS score and RSD in patients treated conservatively after a first episode of shoulder dislocation were reported. The only risk factors with a significant association to RSD were high-risk working activities and rotator cuff injury.