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Sample records for anterior shoulder instability

  1. Mini-Open Latarjet Procedure for Recurrent Anterior Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Numa Mercier

    2011-01-01

    Full Text Available Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure.

  2. Posterior shoulder pain and anterior instability: a preliminary clinical study.

    Science.gov (United States)

    Castagna, Alessandro; Conti, Marco; Borroni, Mario; Massazza, Giuseppe; Vinci, Enzo; Franceschi, Giorgio; Garofalo, Raffaele

    2008-02-01

    Different clinical tests have been suggested in the literature as significant indicators of anterior shoulder instability. Sometimes patients with recurrent anterior shoulder instability may show some muscular guarding thus making the evaluation of specific clinical tests very difficult. These patients may also report a medical history with posterior shoulder pain that can be also elicited during some clinical manoeuvres. From September 2005 to September 2006 we prospectively studied patients who underwent an arthroscopic anterior capsuloplasty. Shoulder clinical examination was performed including anterior shoulder instability tests (drawer, apprehension and relocation tests). Furthermore the exam was focused on the presence of scapular dyskinesia and posterior shoulder pain. The patients were also evaluated with ASES, Rowe, SST (Simple Shoulder Test), Constant and UCLA (University of California at Los Angeles) scoring system preoperatively and at the latest follow-up time. In the period of this study we observed 16 patients treated for anterior gleno-humeral arthroscopic stabilisation, who preoperatively complained also of a posterior scapular pain. The pain was referred at the level of lower trapezium and upper rhomboids tendon insertion on the medial border of the scapula. It was also reproducible upon local palpation by the examiner. Four of these patients also referred pain in the region of the insertion of the infraspinatus and teres minor. After arthroscopic stabilisation the shoulder was immobilised in a sling with the arm in the neutral rotation for a period of 4 weeks. A single physician supervised shoulder rehabilitation. After a mean time of 6.8 months of follow-up, all the shoulder scores were significantly improved and, moreover, at the same time the patients referred the disappearance of the posterior pain. Posterior scapular shoulder pain seems to be another complaint and sign that can be found in patients affected by anterior shoulder instability

  3. Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

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    Durban, Claire Marie C.; Kim, Je Kyun; Kim, Sae Hoon

    2016-01-01

    Background The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed. PMID:27247742

  4. Shoulder Instability

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    ... Risk Factors Is shoulder instability the same as shoulder dislocation? No. The signs of dislocation and instability might ... the same to you--weakness and pain. However, dislocation occurs when your shoulder goes completely out of place. The shoulder ligaments ...

  5. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

    OpenAIRE

    Ee, Gerard WW; Mohamed, Sedeek; Tan, Andrew HC

    2011-01-01

    Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008). Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture ...

  6. Shoulder instability

    International Nuclear Information System (INIS)

    Shoulder instability is a common clinical feature leading to recurrent pain and limitated range of motion within the glenohumeral joint. Instability can be due a single traumatic event, general joint laxity or repeated episodes of microtrauma. Differentiation between traumatic and atraumatic forms of shoulder instability requires careful history and a systemic clinical examination. Shoulder laxity has to be differentiated from true instability followed by the clinical assessment of direction and degree of glenohumeral translation. Conventional radiography and CT are used for the diagnosis of bony lesions. MR imaging and MR arthrography help in the detection of soft tissue affection, especially of the glenoid labrum and the capsuloligamentous complex. The most common lesion involving the labrum is the anterior labral tear, associated with capsuloperiostal stripping (Bankart lesion). A number of variants of the Bankart lesion have been described, such as ALPSA, SLAP or HAGL lesions. The purpose of this review is to highlight different forms of shoulder instability and its associated radiological findings with a focus on MR imaging. (orig.)

  7. Treatment of Anterior Shoulder Instability with Inside-to-Out Technique

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    Elmi, A; A. R. Rouhani

    2010-01-01

    Introduction & Objective: Shoulder joint is the most common articular dislocations in the body. There are many surgical techniques for the treatment of recurrent shoulder dislocation. The aim of the study is to evaluate the short-term results of surgical technique of modified Bankart repair for recurrent anterior shoulder instability.Materials & Methods: Twenty patients underwent an operation at Tabriz Shohada hospital, from May 2005 to december 2007 and were followed up for at least 18 month...

  8. Magnetic resonance imaging arthrography of traumatic anterior instability of the shoulder

    International Nuclear Information System (INIS)

    Recently arthroscopic Bankart suture repair has been performed for the traumatic anterior instability of the shoulder. We investigated the use of MR arthrography in the diagnosis of anterior instability of the shoulder. The purpose of this study was to compare MR arthrography findings of an anterior inferior glenohumeral ligament-labrum complex with arthroscopic findings. Fifty shoulders with traumatic initial anterior dislocation and 50 shoulders with recurrent anterior dislocation and 10 shoulders of a control group without complaints were evaluated. Spin echo T1-weighted images in the transaxial plane and oblique coronal plane were obtained after injecting 20 ml of Gd-DTPA diluted with saline (1:100). Bankart lesion was evaluated by MR arthrography according to Hirose's classification (Type Na, Nb, 1a, 1b, 2, 3). There was a difference in the type of Bankart lesion between traumatic initial anterior dislocation and recurrent anterior dislocation. In the thickness of the anterior inferior glenohumeral ligament (AIGHL), there was a significant correlation between traumatic initial anterior dislocation and recurrent anterior dislocation (p<0.01) although the types of Bankart lesion were not related to the number of dislocation. Secondly, MR arthrography findings were compared with the Arthroscopic findings in 97 shoulders of 97 patients with recurrent shoulder dislocation. Arthroscopic findings were classified according to Kurokawa's classification (Type 1, 2n, 2a, 3n, 3a, 4a). MR arthrography findings of the Bankart lesion significantly correlated with the arthroscopic findings (p<0.01). MR arthrography clearly visualized AIGHL and was helpful in determining operative indications. (author)

  9. Shoulder instability

    International Nuclear Information System (INIS)

    In the shoulder, the advantages of range of motion are traded for the disadvantages of vulnerability to injury and the development of instability. Shoulder instability and the lesion it produces represent one of the main causes of shoulder discomfort and pain. Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to their causative factors as the pathogenesis of instability plays an important role with respect to treatment options: instabilities are classified in traumatic and atraumatic instabilities as part of a multidirectional instability syndrome, and in microtraumatic instabilities. Plain radiographs ('trauma series') are performed to document shoulder dislocation and its successful reposition. Direct MR arthrography is the most important imaging modality for delineation the different injury patterns on the labral-ligamentous complex and bony structures. Monocontrast CT-arthrography with use of multidetector CT scanners may be an alternative imaging modality, however, regarding the younger patient age, MR imaging should be preferred in the diagnostic work-up of shoulder instabilities. (orig.)

  10. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

    Directory of Open Access Journals (Sweden)

    Tan Andrew HC

    2011-06-01

    Full Text Available Abstract Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008. Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA shoulder rating scale and the Simple Shoulder Test (SST score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

  11. Increasing preoperative dislocations and total time of dislocation affect surgical management of anterior shoulder instability

    OpenAIRE

    Denard, Patrick J.; Xuesong Dai; Burkhart, Stephen S.

    2015-01-01

    Purpose: Our purpose was to determine the relationship between number of preoperative shoulder dislocations and total dislocation time and the need to perform bone deficiency procedures at the time of primary anterior instability surgery. Our hypothesis was that need for bone deficiency procedures would increase with the total number and hours of dislocation. Materials and Methods: A retrospective review was performed of primary instability surgeries performed by a single surgeon. Patient...

  12. Frequency of glenoid chondral lesions on MR arthrography in patients with anterior shoulder instability

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    O' Brien, J., E-mail: juliemobrien@gmail.com [Department of Radiology, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5 (Canada); Grebenyuk, J., E-mail: julia.grebenyuk@utoronto.ca [Department of Radiology, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5 (Canada); Leith, J., E-mail: jleith@shaw.ca [Department of Orthopaedic Surgery, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5 (Canada); Forster, B.B., E-mail: Bruce.Forster@vch.ca [Department of Radiology, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5 (Canada)

    2012-11-15

    Purpose: To describe the frequency of glenoid chondral abnormalities in relation to Hill Sachs (HS) lesions in MR arthrograms of patients with anterior shoulder instability versus controls. Such glenoid lesions can directly impact surgical decision-making and approach, and potentially negatively impact outcome if missed. Materials and methods: Retrospective analysis of direct MR shoulder arthrograms in 165 subjects, (101 with anterior instability/64 controls) was performed independently by 2 blinded musculoskeletal radiologists. Outcome measures were the presence of a HS, anterior labral pathology and glenoid chondral injury. Kappa statistic, Pearson Chi-square and Mann-Whitney analysis were employed for analysis. Results: Inter-observer variability for the presence of HS, labral and chondral lesions was 0.964, 0.965 and 0.858 respectively, with intra-observer variability of 1.0, 0.985 and 0.861 for the principle reader. 58% of patients and 8% of controls had HS (p < 0.001). 72% of patients and 25% of controls had anterior labral injury (p < 0.001). 36% of instability patients and 10% controls had glenoid chondral lesions (p < 0.001). 46% of anterior instability patients with HS defects had chondral injury as opposed to 21% of patients without HS defects (p = 0.009). Depth of the HS lesion did not increase the likelihood of a glenoid chondral lesion (p = 0.7335). Conclusion: In the clinical anterior instability cohort, we demonstrated a statistically significant higher number of HS and glenoid chondral lesions than in controls. In anterior instability patients, the presence of a HS lesion confers a statistically significant greater likelihood of having a glenoid chondral lesion when compared to patients with instability and no HS.

  13. Frequency of glenoid chondral lesions on MR arthrography in patients with anterior shoulder instability

    International Nuclear Information System (INIS)

    Purpose: To describe the frequency of glenoid chondral abnormalities in relation to Hill Sachs (HS) lesions in MR arthrograms of patients with anterior shoulder instability versus controls. Such glenoid lesions can directly impact surgical decision-making and approach, and potentially negatively impact outcome if missed. Materials and methods: Retrospective analysis of direct MR shoulder arthrograms in 165 subjects, (101 with anterior instability/64 controls) was performed independently by 2 blinded musculoskeletal radiologists. Outcome measures were the presence of a HS, anterior labral pathology and glenoid chondral injury. Kappa statistic, Pearson Chi-square and Mann–Whitney analysis were employed for analysis. Results: Inter-observer variability for the presence of HS, labral and chondral lesions was 0.964, 0.965 and 0.858 respectively, with intra-observer variability of 1.0, 0.985 and 0.861 for the principle reader. 58% of patients and 8% of controls had HS (p < 0.001). 72% of patients and 25% of controls had anterior labral injury (p < 0.001). 36% of instability patients and 10% controls had glenoid chondral lesions (p < 0.001). 46% of anterior instability patients with HS defects had chondral injury as opposed to 21% of patients without HS defects (p = 0.009). Depth of the HS lesion did not increase the likelihood of a glenoid chondral lesion (p = 0.7335). Conclusion: In the clinical anterior instability cohort, we demonstrated a statistically significant higher number of HS and glenoid chondral lesions than in controls. In anterior instability patients, the presence of a HS lesion confers a statistically significant greater likelihood of having a glenoid chondral lesion when compared to patients with instability and no HS.

  14. Modified Latarjet Procedure for Patients with Glenoid Bone Defect Accompanied with Anterior Shoulder Instability.

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    Demirhan, Mehmet Selahattin; Atalar, Ata Can; Bilsel, Kerem; Eren, İlker; Çelik, Derya; Çil, Hilal

    2013-01-01

    Abstract: Objective: The aim of this study was to assess the effects of coracoid bone block (modified Latarjet) procedure on clinical and functional results in cases with glenoid bone defect accompanied with anterior shoulder instability. Methods: The study included 35 patients (average age: 35 years; range: 20 to 58 years) with glenoid bone defect and recurrent dislocations treated with the modified Latarjet procedure. There were 12 sports injuries, 5 post-epileptic cases and 18 recurrent an...

  15. Bilateral anterior shoulder dislocation

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    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  16. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

    Directory of Open Access Journals (Sweden)

    Guity MR

    2010-10-01

    Full Text Available "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instability of the shoulder were evaluated. At the time of follow-up (mean of thirty-three months, the patients were assessed with two outcome measurement tools (the Rowe score, the Constant score. The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated."n "nResults: According to the Rowe scale, 12 patients (40% had an excellent score; 13 (43%, a good score; 4 (13%, a fair score; and 1 (4%, a poor score. The mean ROWE score was 81.8 and the mean CONSTANT score was 85.5. Overall, the rate of postoperative recurrence of instability was 10% (two dislocations, one subluxation. The mean delay to recurrence was 20 months. Loss of external rotation in regard to uninvolved extremity was less than 10 degrees in 30% and more than 10 degrees in 10% of patients. The average number of anchors used was 3.2 which follow-up radiographs showed all of them in the osseous glenoid without pullout. In preoperative studies, shoulder 3D CT scan was not performed routinely. Radiographic signs of degenerative changes were noted in one shoulder."n "nConclusion: Arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.

  17. Evaluation of Oxford instability shoulder score, Western Ontario shoulder instability Index and Euroqol in patients with slap (superior labral anterior posterior) lesions or recurrent anterior dislocations of the shoulder

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    Skare, Øystein; Liavaag, Sigrud; Reikerås, Olav; Mowinckel, Petter; Brox, Jens Ivar

    2013-01-01

    Background Having an estimate of the measurement error of self-report questionnaires is important both for assessing follow-up results after treatment and when planning intervention studies. Specific questionnaires have been evaluated for patients with shoulder instability, but not in particular for patients with SLAP (superior labral anterior posterior) lesions or recurrent dislocations. The aim of this study was to evaluate the agreement, reliability, and validity of two commonly questionna...

  18. Treatment of Anterior Shoulder Instability with Inside-to-Out Technique

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    A. Elmi

    2010-01-01

    Full Text Available Introduction & Objective: Shoulder joint is the most common articular dislocations in the body. There are many surgical techniques for the treatment of recurrent shoulder dislocation. The aim of the study is to evaluate the short-term results of surgical technique of modified Bankart repair for recurrent anterior shoulder instability.Materials & Methods: Twenty patients underwent an operation at Tabriz Shohada hospital, from May 2005 to december 2007 and were followed up for at least 18 months. The data was analyzed by descriptive statistical methods.Results: There were 85% male and 15%female participants in the study, with the average age of 24.7 years(14-46years. The mean number of dislocation episode before surgery was 6(3-11. Two had minor glenoid rim fracture. There was no case of rotator cuff tear. During the follow up after surgery, two patients had recurrence of dislocation. The mean Rowe score was 94 and no infection or neurological complication was reported. Average external rotation loss was 5º.Conclusion: According to the above-mentioned data, modified bankart procedure is an acceptable method for treatment of recurrent dislocation of the shoulder.

  19. Gene expression analysis in patients with traumatic anterior shoulder instability suggests deregulation of collagen genes.

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    Belangero, Paulo Santoro; Leal, Mariana Ferreira; Figueiredo, Eduardo Antônio; Cohen, Carina; Pochini, Alberto de Castro; Smith, Marília Cardoso; Andreoli, Carlos Vicente; Belangero, Sintia Iole; Ejnisman, Benno; Cohen, Moises

    2014-10-01

    Shoulder dislocation occurs in 1-2% of the population. Capsular deformation is a key factor in shoulder dislocation; however, little is known about capsule biology. We evaluated, for the first time in literature, the expression of COL1A1, COL1A2, COL3A1 and COL5A1 in the antero-inferior, antero-superior and posterior regions of the glenohumeral capsule of 31 patients with anterior shoulder instability and eight controls. The expression of collagen genes was evaluated by quantitative reverse transcription-PCR. The expression of COL1A1, COL3A1 and the ratio of COL1A1/COL1A2 were increased in all three portions of the capsule in patients compared to controls (p < 0.05). COL1A2 expression was upregulated in the antero-superior and posterior sites of the capsule of patients (p < 0.05). The ratio of COL1A2/COL3A1 expression was reduced in capsule antero-inferior and posterior sites of patients compared to controls (p < 0.05). In the capsule antero-inferior site of patients, the ratios of COL1A1/COL5A1, CO1A2/COL5A1 and COL3A1/COL5A1 expression were increased (p < 0.05). In patients, COL1A1/COL5A1 was also increased in the posterior site (p < 0.05). We found deregulated expression of collagen genes across the capsule of shoulder instability patients. These molecular alterations may lead to modifications of collagen fibril structure and impairment of the healing process, possibly with a role in capsular deformation. PMID:25042113

  20. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

    OpenAIRE

    Santosh Kumar; Anant Kumar; Sanjay

    2015-01-01

    BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A sut...

  1. Evaluating shoulder instability treatment

    OpenAIRE

    Linde, J. A.

    2016-01-01

    Shoulder instability common occurs. When treated nonoperatively, the resulting societal costs based on health care utilization and productivity losses are significant. Shoulder function can be evaluated using patient reported outcome measurements (PROMs). For shoulder instability, these include the Western Ontario Shoulder Instability index (WOSI) and the Oxford Shoulder Instability Score (OSIS). When translated and validated for the dutch population, both have good measurment properties. Sco...

  2. Double contrast CT diagnosis of shoulder instability

    International Nuclear Information System (INIS)

    Purpose: To study clinical importance of double contrast CT arthrography in the diagnosis of shoulder instability. Materials and methods: Eight patients were diagnosed as having shoulder instability with double contrast CT. The technique involved injection of 4 ml, 76% urografin and 10 ml of room air through an anterior shoulder puncture. The CT images were obtained with the patients supine and prone position. Results: The results of the CT arthrography were confirmed during the surgical operation afterward. The characteristics of abnormal double contrast CT arthrograms. They included anterior labral tear: the rounded anterior glenoid labrum, detached anterior labrum and anterior labral fragment; anterior capsular stripping off the anterior scapular glenoid neck; and enlargement of anterior and posterior capsular stripping off the anterior scapular glenoid neck; and enlargement of anterior and posterior capsular cavity. Conclusion: The current CT arthrography provides important X-ray information for both diagnosis of shoulder instability and anatomical repair of shoulder instability

  3. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

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    Guity MR; Sianati S

    2010-01-01

    "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instabil...

  4. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2015-06-01

    Full Text Available BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A suture anchor is a tiny screw with a thread attached to it. The screw is inserted into the bone over the glenoid rim while the sutures hold onto the labral tissue. These anchors provide a stable base for reattachment of the capsulolabral complex. We conducted a study on evaluation of long term effe ct of arthroscopic repair of Bankart’s lesion using suture anchors and compared our results with other studies published in literature . MATERIALS & METHODS : Since June 2012, arthroscopic Bankart’s repair using suture anchors was performed on 35 patients, who presented with recurrent anterior dislocation of shoulder. 34 man and 1 woman patients were included in the study. METHOD OF COLLECTION OF DATA: Adult patients with recurrent dislocations of shoulder with . INCLUSION CRITERIA: All patients > 15 years but =2 . EXCLUSION CRITERIA: Age group 60 years. Clinical evidence of multidirectional instability. Surgery of injured shou lder before 1 st episode of traumatic shoulder dislocation. Number o f dislocations <2 . Generalised ligamentous laxity. Presence of neuromuscular disorders. Presence of other comorbid conditions . Majority of patients were in the age group between 17 years to 49years, with mean age of 27.43 years. Most patients were young active individuals in the age group of 25 to 35 years. 20 patients (57% were involved in significant occupation requiring overhead activity such as students with sporting activities, agricul turists. 21(60% patients had their Right shoulder involved

  5. Rugby Union on-field position and its relationship to shoulder injury leading to anterior reconstruction for instability.

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    Sundaram, Abayasankar; Bokor, Desmond J; Davidson, Andrew S

    2011-03-01

    Due to the unique demands of each position on the Rugby Union field, the likelihood of an athlete sustaining a dislocation of their shoulder joint that requires surgical reconstruction may be affected by their position on the field. 166 patients with 184 involved shoulders requiring anterior reconstruction following an on-field Rugby Union injury between January 1996 and September 2008 were analysed. The mean age at time of injury was 18 years with the mean age at time of surgery being 20 years. The most prevalent mechanism of injury was a tackle in 66.3% of players. Players were more likely to suffer injury to their non-dominant shoulder than their dominant side (McNemar's Test, p<0.001). Statistical analysis using chi-squared test of goodness of fit showed there was not a uniform risk of injury for all player positions. Positions with significantly different risk of injury were five-eighth (increased risk) and wing (reduced risk). Although we observed an increased risk in flankers and fullbacks, and a lower risk in second row, these results did not reach statistical significance after application of the Bonferroni correction. This information can be utilized by team staff to assist in pre-season conditioning as well as the development of improved muscle co-ordination programmes for the non-dominant shoulder, and planning a graduated return to sport by the player recovering from surgical reconstruction of the shoulder for instability. PMID:20864398

  6. Expression analysis of genes involved in collagen cross-linking and its regulation in traumatic anterior shoulder instability.

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    Belangero, Paulo Santoro; Leal, Mariana Ferreira; Cohen, Carina; Figueiredo, Eduardo Antônio; Smith, Marília Cardoso; Andreoli, Carlos Vicente; de Castro Pochini, Alberto; Ejnisman, Benno; Cohen, Moises

    2016-03-01

    The molecular alterations involved in the capsule deformation presented in shoulder instability patients are poorly understood. Increased TGFβ1 acts as a signal for production of matrix macromolecules by fibrogenic cells at joint injury sites. TGFβ1, through its receptor TGFβR1, regulates genes involved in collagen cross-linking, such as LOX, PLOD1, and PLOD2. We evaluated TGFβ1, TGFβR1, LOX, PLOD1, and PLOD2 gene expression in the antero-inferior (macroscopically injured region), antero-superior and posterior regions of the glenohumeral capsule of 29 shoulder instability patients and eight controls. We observed that PLOD2 expression was increased in the anterior-inferior capsule region of the patients compared to controls. LOX expression tended to be increased in the posterior portion of patients. Patients with recurrent shoulder dislocation presented upregulation of TGFβR1 in the antero-inferior capsule portion and of PLOD2 in the posterior region. Conversely, LOX was increased in the posterior portion of the capsule of patients with a single shoulder dislocation episode. In the antero-inferior, LOX expression was inversely correlated and TGFβR1 was directly correlated with the duration of symptoms. In the posterior region, PLOD2, TGFβ1, and TGFβR1 were directly correlated with the duration of symptoms. In conclusion, PLOD2 expression was increased in the macroscopically injured region of the capsule of patients. Upregulation of TGFβ1, TGFβR1, and PLOD2 seems to be related with the maintenance of disease symptoms, especially in the posterior region. LOX upregulation seems to occur only in the initial phase of the affection. Therefore, TGFβ1, TGFβR1, LOX, and PLOD2 may play a role in shoulder instability. PMID:26185036

  7. Systematics of shoulder instability

    International Nuclear Information System (INIS)

    Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to the causative factors as the pathogenesis of instability plays an important role with respect to treatment options. Instabilities are classified into traumatic and atraumatic instabilities as part of a multidirectional instability syndrome and into microtraumatic instabilities. For diagnostics plain radiographs (''trauma series'') are performed to document shoulder dislocation and its successful repositioning. Direct magnetic resonance (MR) arthrography is the most important imaging modality for delineation of the different injury patterns of the labral-ligamentous complex and bony structures. Monocontrast computed tomography (CT) arthrography with the use of multidetector CT scanners represents an alternative imaging modality; however, MR imaging should be preferred in the work-up of shoulder instabilities due to the mostly younger age of patients. (orig.)

  8. Shoulder instability; Schulterinstabilitaeten

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    Kreitner, Karl-Friedrich [Mainiz Univ. (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2014-06-15

    In the shoulder, the advantages of range of motion are traded for the disadvantages of vulnerability to injury and the development of instability. Shoulder instability and the lesion it produces represent one of the main causes of shoulder discomfort and pain. Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to their causative factors as the pathogenesis of instability plays an important role with respect to treatment options: instabilities are classified in traumatic and atraumatic instabilities as part of a multidirectional instability syndrome, and in microtraumatic instabilities. Plain radiographs ('trauma series') are performed to document shoulder dislocation and its successful reposition. Direct MR arthrography is the most important imaging modality for delineation the different injury patterns on the labral-ligamentous complex and bony structures. Monocontrast CT-arthrography with use of multidetector CT scanners may be an alternative imaging modality, however, regarding the younger patient age, MR imaging should be preferred in the diagnostic work-up of shoulder instabilities. (orig.)

  9. Shoulder instability; Schultergelenkinstabilitaet

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    Sailer, J.; Imhof, H. [Abteilung Osteoradiologie, Univ.-Klinik fuer Radiodiagnostik Wien (Austria)

    2004-06-01

    Shoulder instability is a common clinical feature leading to recurrent pain and limitated range of motion within the glenohumeral joint. Instability can be due a single traumatic event, general joint laxity or repeated episodes of microtrauma. Differentiation between traumatic and atraumatic forms of shoulder instability requires careful history and a systemic clinical examination. Shoulder laxity has to be differentiated from true instability followed by the clinical assessment of direction and degree of glenohumeral translation. Conventional radiography and CT are used for the diagnosis of bony lesions. MR imaging and MR arthrography help in the detection of soft tissue affection, especially of the glenoid labrum and the capsuloligamentous complex. The most common lesion involving the labrum is the anterior labral tear, associated with capsuloperiostal stripping (Bankart lesion). A number of variants of the Bankart lesion have been described, such as ALPSA, SLAP or HAGL lesions. The purpose of this review is to highlight different forms of shoulder instability and its associated radiological findings with a focus on MR imaging. (orig.) [German] Die Schultergelenkinstabilitaet ist haeufig fuer wiederholt auftretende Schmerzen sowie eine eingeschraenkte Beweglichkeit im Glenohumeralgelenk verantwortlich. Sie kann als Folge eines vorangegangenen Traumas, einer generellen Hyperlaxitaet oder infolge wiederholter Mikrotraumen entstehen. Die Differenzierung zwischen traumatischer und atraumatischer Form der Gelenkinstabilitaet erfordert eine sorgfaeltige Anamnese und eine genaue klinische Untersuchung. Die Gelelenklaxitaet als Differenzialdiagnose muss von der echten Instabilitaet unterschieden werden, die Instabilitaet wird dann im Rahmen des klinischen Status nach Grad und Richtung der glenohumeralen Translation unterteilt. Zur Diagnose knoecherner Laesionen werden das konventionelle Roentgen sowie die CT herangezogen. MRT sowie MR-Arthrographie dienen zur Detektion

  10. Shoulder instability : A clinical and MRI-based analysis

    OpenAIRE

    Salomonsson, Björn

    2009-01-01

    Shoulder instability is a common but complex and challenging area of shoulder pathology, and new diagnostic methods and treatments are continuously developed. We conducted this study to evaluate the clinical outcome of shoulder instability with respect to different diagnostic possibilities and surgical treatments. We have studied the patient material from our department, consisting of atraumatic instability, posttraumatic recurrent anterior instability, and primary shoul...

  11. Early Clinical Results of Arthroscopic Remplissage in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran

    OpenAIRE

    Hamid Reza Aslani; Zohreh Zafarani; Adel Ebrahimpour; Shahin Salehi; Ali Moradi; Soheil Sabzevari

    2014-01-01

    Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion...

  12. Muscle activation patterns in patients with recurrent shoulder instability

    Directory of Open Access Journals (Sweden)

    Anju Jaggi

    2012-01-01

    Conclusion: The DEMG results suggest that increased activation of LD may play a role in both anterior and posterior shoulder instability; increased activation of PM may play a role in anterior instability.

  13. Early Clinical Results of Arthroscopic Remplissages in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran

    Directory of Open Access Journals (Sweden)

    Hamid Reza Aslani

    2014-03-01

    Full Text Available Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion limitation.     Results:   During the internal follow up period no case of recurrence was found. Motion limitation during the follow up   period was not significant (internal rotation limitation=5°±1°, and external rotation limitation=4°±1° Conclusions:   Our findings suggest that the remplissage arthroscopic surgical method is an acceptable, safe and   reliable treatment for anterior shoulder dislocation with engaging Hill-Sachs lesion.

  14. Tratamento artroscópico da instabilidade anterior do ombro: estudo retrospectivo de 159 casos Anterior instability of the shoulder: retrospective study on 159 cases

    Directory of Open Access Journals (Sweden)

    Arnaldo Amado Ferreira Neto

    2011-01-01

    Full Text Available OBJETIVO: Análise dos resultados de 159 pacientes com instabilidade anterior do ombro submetidos ao tratamento artroscópico de janeiro de 2001 a dezembro de 2005. MÉTODOS: Estudo retrospectivo de prontuários com dados completos. RESULTADOS: Em 108 pacientes notou-se a lesão de Bankart e em 62 pacientes a lesão do tipo SLAP estava presente. Utilizou-se em média 2,7 âncoras. Apresentaram complicações 42 casos; 14 tinham dor aos esforços, 12 tinham algum grau de diminuição da rotação externa, 16 apresentaram recidiva. Os pacientes que evoluíram com complicações utilizaram em média 2,5 âncoras, enquanto naqueles sem complicações a média foi de 2,8 (pOBJECTIVE: To analyze the results of 159 patients with anterior instability of the shoulder submitted to arthroscopic treatment from January 2001 to December 2005. METHODS: Retrospective study of complete patient records. RESULTS: In 108 patients the Bankart lesion was found, while in 62 patients, SLAP type lesions were found. An average of 2.7 anchors was used. 42 cases presented complications; 14 had pain on effort, 12 had some degree of reduction of external rotation, and 16 had recorrence. The patients who developed complications used an average of 2.5 anchors, while those without complications used an average of 2.8 anchors (p<0.05. Of the 35 patients with anterior glenoid bone lesion, 8 had recorrence, while of the 124 patients without fractures, 8 had recorrence (p<0.05. Of the 113 patients with first-time traumatic dislocations, 12 developed limitation of external rotation, while in 46 atraumatic cases none developed limitation (p<0.05. Of the patients with SLAP lesion, 11 developed pain, while in the cases without this lesion, only 3 presented pain (p<0.05. CONCLUSION: There were more recurrences (deveria ser plural e recurrences, nao recurrence in cases of anterior glenoid bone lesion. Post-operative pain was more frequent when the lesion type was SLAP. Limitation of

  15. The quantification of glenoid bone loss in anterior shoulder instability; MR-arthro compared to 3D-CT

    International Nuclear Information System (INIS)

    The purpose of this study is to investigate if magnetic resonance imaging with intra-articular contrast (MR-arthro) is as reliable as three-dimensionally reconstructed computed tomography imaging (3D-CT) in quantifying the glenoid bone loss in patients with anterior shoulder instability. Thirty-five patients were included. Sagittal MR-arthro and 3D-CT images of the glenoid surface were obtained pre-operatively. Two observers measured these images twice with OsiriX software in a randomized and blinded way. The intraclass correlations (ICC) of the intra- and inter-observer reliability within one method and an additional Bland-Altman plot for calculating agreement between the two methods were obtained. The joint estimates of the intra-observer reliability, taking into account the data from both observer A and B, for 3D-CT and MR-arthro were good to excellent. The intra-observer reliability was 0.938 (95 % CI: 0.879, 0.968) for 3D-CT and 0.799 (95 % CI: 0.639, 0.837) for MR-arthro. The inter-observer reliability between the two observers within one method (3D-CT or MR-arthro) was moderate to good. 3D-CT: 0.724 (95 % CI: 0.236, 0.886) and MR-arthro: 0.534 (95 % CI: 0.128, 0.762). Comparing both the 3D-CT and MR-arthro method, a Bland-Altman plot showed satisfying differences with the majority of outcomes (89 %) within 1 SD. Good to excellent intra- and moderate to good inter-observer correlations and a satisfying Bland-Altman plot when compared to 3D-CT show tendencies that MR-arthro is reliable and valid for measuring bony defects of the glenoid. (orig.)

  16. Intra-observer and interobserver reliability of the 'Pico' computed tomography method for quantification of glenoid bone defect in anterior shoulder instability

    International Nuclear Information System (INIS)

    To evaluate the intra-observer and interobserver reliability of the 'Pico' computed tomography (CT) method of quantifying glenoid bone defects in anterior glenohumeral instability. Forty patients with unilateral anterior shoulder instability underwent CT scanning of both shoulders. Images were processed in multiplanar reconstruction (MPR) to provide an en face view of the glenoid. In accordance with the Pico method, a circle was drawn on the inferior part of the healthy glenoid and transferred to the injured glenoid. The surface of the missing part of the circle was measured, and the size of the glenoid bone defect was expressed as a percentage of the entire circle. Each measurement was performed three times by one observer and once by a second observer. Intra-observer and interobserver reliability were analyzed using intraclass correlation coefficients (ICCs), 95% confidence intervals (CIs), and standard errors of measurement (SEMs). Analysis of intra-observer reliability showed ICC values of 0.94 (95% CI = 0.89-0.96; SEM = 1.1%) for single measurement, and 0.98 (95% CI = 0.96-0.99; SEM = 1.0%) for average measurement. Analysis of interobserver reliability showed ICC values of 0.90 (95% CI = 0.82-0.95; SEM = 1.0%) for single measurement, and 0.95 (95% CI = 0.90-0.97; SEM = 1.0%) for average measurement. Measurement of glenoid bone defect in anterior shoulder instability can be assessed with the Pico method, based on en face images of the glenoid processed in MPR, with a very good intra-observer and interobserver reliability. (orig.)

  17. Indirect MR arthrography of anterior shoulder instability in the ABER and the apprehension test positions: a prospective comparative study of two different shoulder positions during MRI using intravenous gadodiamide contrast for enhancement of the joint fluid

    International Nuclear Information System (INIS)

    The value of MRI for the evaluation of anterior shoulder instability can be enhanced by shoulder positions that stress the stabilising structures. The ABER position is one that has been described in combination with intra-articular gadopentetate dimeglumine arthrography. We believe that MRI in the Apprehension test position with 90 abduction and maximal tolerable external rotation provides maximum tension on the anterior stabilising structures and with this technique it is sufficient to use indirect gadodiamide arthrography following intravenous injection of the contrast medium. The purpose of this study was to make a prospective comparative evaluation of the ABER and Apprehension test positions when using indirect arthrography with intravenous gadodiamide administration in shoulders with anterior instability. Results. Both the ABER and the Apprehension test position were useful techniques in detecting capsulolabral pathology and Hill-Sachs lesions. The Apprehension test position produced significantly better gadodiamide-enhanced joint fluid in the region of pathology in both the capsulolabral lesion and the Hill-Sachs lesion. It also visualised the size of the Hill-Sachs lesion significantly better than did the ABER position. (orig.)

  18. Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability

    International Nuclear Information System (INIS)

    Objective. To assess the shape of the posterior glenoid rim in patients with recurrent (atraumatic) posterior instability.Design and patients. CT examinations of 15 shoulders with recurrent (atraumatic) posterior instability were reviewed in masked fashion with regard to abnormalities of the glenoid shape, specifically of its posterior rim. The glenoid version was also assessed. The findings were compared with the findings in 15 shoulders with recurrent anterior shoulder instability and 15 shoulders without instability. For all patients, surgical correlation was available.Results. Fourteen of the 15 (93%) shoulders with recurrent (atraumatic) posterior shoulder instability had a deficiency of the posteroinferior glenoid rim. In patients with recurrent anterior instability or stable shoulders such deficiencies were less common (60% and 73%, respectively). The craniocaudal length of the deficiencies was largest in patients with posterior instability. When a posteroinferior deficiency with a craniocaudal length of 12 mm or more was defined as abnormal, sensitivity and specificity for diagnosing recurrent (atraumatic) posterior instability were 86.7% and 83.3%, respectively. There was a statistically significant difference in glenoid version between shoulders with posterior instability and stable shoulders (P=0.01).Conclusion. Recurrent (atraumatic) posterior shoulder instability should be considered in patients with a bony deficiency of the posteroinferior glenoid rim with a craniocaudal length of more than 12 mm. (orig.)

  19. A Rare Complication of Tuberculous Meningitis Pediatric Anterior Glenohumeral Instability

    Directory of Open Access Journals (Sweden)

    Kerem Bilsel

    2012-01-01

    Full Text Available Dislocation and instability of the shoulder joint are rare occurrences in childhood. Traumatic, infectious, congenital, and neuromuscular causes of pediatric recurrent shoulder dislocations are reported before. Central nervous system infection in infancy may be a reason for shoulder instability during childhood. This situation, which causes a disability for children, can be treated successfully with arthroscopic stabilization of the shoulder and postoperative effective rehabilitation protocols. Tuberculous meningitis may be a reason for neuromuscular shoulder instability. We describe a 12-year-old child with a recurrent anterior instability of the shoulder, which developed after tuberculous meningitis at 18 months of age. We applied arthroscopic treatment and stabilized the joint.

  20. Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report

    OpenAIRE

    Schneider, Marco Michael; Balke, Maurice; Koenen, Paola; Bouillon, Bertil; Banerjee, Marc

    2014-01-01

    Introduction Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described. Case presentation A 32-year-old German man presented to our department with a history of recurrent shoulder dislocations. He was diagnosed with an avulsion fra...

  1. Shoulder MRI after surgical treatment of instability

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, Martin [University of Bonn, Department of Radiology, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Lang, Philipp [University of California San Francisco, Department of Radiology, 505 Pamassus Avenue, San Francisco, CA 94143 (United States); Wagner, Ulli [University of Bonn, Department of Orthopedic Surgery, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Moeller, Frank [University of Bonn, Department of Orthopedic Surgery, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Deimling, Urs van [University of Bonn, Department of Orthopedic Surgery, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Genant, H.K. [University of California San Francisco, Department of Radiology, 505 Pamassus Avenue, San Francisco, CA 94143 (United States); Schild, Hans H. [University of Bonn, Department of Radiology, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany)

    1999-04-01

    Objective: To analyze magnetic resonance imaging (MRI) findings of the shoulder after an instability operation. Materials and methods: Physical examinations, radiographs and MRI of 10 patients after anterior glenoid bone block insertion for ventral instability were compared. MRI included T{sub 1}-weighted spin-echo (TR=600, TE=20 ms) and T{sub 2}*-weighted gradient-echo sequences (TE=600, TE=18, Flip=30 deg.) in the axial, oblique-coronal and oblique-sagittal planes. Results: No patient suffered from recurrent subluxation. We found fusion of the bone block with the anterior glenoid in seven cases, dislocation of the bone block without contact to the glenoid in one case, and no visible bone block in two cases. On MRI, the bone block showed either signal intensity equivalent to fatty bone marrow (n=4) or was devoid of signal consistent with cortical bone or bone sclerosis (n=4). In all patients, a low signal intensity mass, 2-4 cm in diameter, was visible next to the glenoid insertion site. Conclusion: Insertion of a bone block onto the anterior glenoid induces formation of scar tissue, increasing the stability of the shoulder joint. This scar is well visible on MRI and forms independently of the behavior of the bone block itself. MRI is ideally suited for evaluating postoperative shoulder joints after bone-grafting procedures.

  2. Shoulder MRI after surgical treatment of instability

    International Nuclear Information System (INIS)

    Objective: To analyze magnetic resonance imaging (MRI) findings of the shoulder after an instability operation. Materials and methods: Physical examinations, radiographs and MRI of 10 patients after anterior glenoid bone block insertion for ventral instability were compared. MRI included T1-weighted spin-echo (TR=600, TE=20 ms) and T2*-weighted gradient-echo sequences (TE=600, TE=18, Flip=30 deg.) in the axial, oblique-coronal and oblique-sagittal planes. Results: No patient suffered from recurrent subluxation. We found fusion of the bone block with the anterior glenoid in seven cases, dislocation of the bone block without contact to the glenoid in one case, and no visible bone block in two cases. On MRI, the bone block showed either signal intensity equivalent to fatty bone marrow (n=4) or was devoid of signal consistent with cortical bone or bone sclerosis (n=4). In all patients, a low signal intensity mass, 2-4 cm in diameter, was visible next to the glenoid insertion site. Conclusion: Insertion of a bone block onto the anterior glenoid induces formation of scar tissue, increasing the stability of the shoulder joint. This scar is well visible on MRI and forms independently of the behavior of the bone block itself. MRI is ideally suited for evaluating postoperative shoulder joints after bone-grafting procedures

  3. RESULTS FROM LATARJET SURGERY FOR TREATING TRAUMATIC ANTERIOR SHOULDER INSTABILITY ASSOCIATED WITH BONE EROSION IN THE GLENOID CAVITY, AFTER MINIMUM FOLLOW-UP OF ONE YEAR

    OpenAIRE

    Ikemoto, Roberto Yukio; Murachovisky, Joel; Nascimento, Luis Gustavo Prata; Bueno, Rogério Serpone; Almeida, Luiz Henrique Oliveira; Strose, Eric; Helmer, Fábio Fernando

    2015-01-01

    Objective: Evaluate the results from the Latarjet procedure in patients with anterior recurrent dislocation of the shoulder who present bone loss of the glenoid cavity greater than 25%. Methods: Twenty six male patients underwent the Latarjet procedure, The bone loss was evaluated by means of radiography using the Bernageau view and by means of CAT scan. The patients were evaluated with regard to range of motion, using the Rowe and UCLA scales, before and after the operation, and by radiograp...

  4. Systematic Review of Arthroscopic Versus Open Repair for Recurrent Anterior Shoulder Dislocations

    OpenAIRE

    Godin, Jonathan; Sekiya, Jon K.

    2011-01-01

    Context: It remains unknown if arthroscopic repair of recurrent anterior shoulder instability is as effective as open repair. Objective: The purpose of this study is to analyze the literature to provide clinical recommendations regarding the most appropriate therapeutic intervention for recurrent anterior shoulder instability. Study Design: Systematic review of level I and II studies. Data Sources: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and secondary references from 1967...

  5. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... instability, or the shoulder dislocating again with other activities. Nonetheless, we always approach these patients first with physical therapy and rehab. So, Joe, maybe if you ...

  6. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... Hospital. Over the next hour you'll see a Bankart repair to correct shoulder instability. Bankart lesions ... three small incisions. You'll also hear from a patient who has undergone the surgery, and meet ...

  7. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available BANKART REPAIR TO CORRECT SHOULDER INSTABILITY AKRON CHILDREN'S HOSPITAL AKRON, OHIO February 21, 2008 00:00:11 NARRATOR: Welcome to Akron Children's Hospital. Over the next hour you'll see a ...

  8. First-time anterior shoulder dislocations: should they be arthroscopically stabilised?

    OpenAIRE

    Sedeek, Sedeek Mohamed; Bin Abd Razak, Hamid Rahmatullah; Ee, Gerard WW; Tan, Andrew HC

    2014-01-01

    The glenohumeral joint is inherently unstable because the large humeral head articulates with the small shadow glenoid fossa. Traumatic anterior dislocation of the shoulder is a relatively common athletic injury, and the high frequency of recurrent instability in young athletes after shoulder dislocation is discouraging to both the patient and the treating physician. Management of primary traumatic shoulder dislocation remains controversial. Traditionally, treatment involves initial immobilis...

  9. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

    OpenAIRE

    Amit Mishra; Pulak Sharma; Deepak Chaudhary

    2012-01-01

    Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 yea...

  10. CT investigation of instability of the shoulder joint

    International Nuclear Information System (INIS)

    CT is able to demonstrate the predisposing factors for recurrent und posttraumatic subluxation of the shoulder . In addition to demonstrating bony changes in the glenoid (Bankart lesion) and in the humeral head (Hill-Sachs lesion), CT can measure the degree of retroversion of the glenoid and torsion of the humerus. Measurements on 17 shoulders with habitual and 24 shoulders with recurrent posttraumatic subluxation showed low values for glenoid retriversion as compared with a control group. Particulary patients with habitual anterior subluxation frequently showed anteversion of the glenoid. Measurements of humeral torsion showed wide scatter amongst all groups, indicating wide biological variability. The results were compared with those published in the literature and the indications and limitations of CT for the investigation of shoulder instability are discussed. (orig.)

  11. Coracoid syndrome: a neglected cause of anterior shoulder pain

    Science.gov (United States)

    GIGANTE, ANTONIO; BOTTEGONI, CARLO; BARBADORO, PAMELA

    2016-01-01

    Purpose the present prospective open-label study was designed to gain further insights into a condition thought to constitute a neglected but not uncommon syndrome characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process, not related to rotator cuff or pectoralis minor tendinopathy, long head of the biceps tendon disorders, or instability. The aim was to clarify its prevalence, clinical characteristics, differential diagnosis and response to corticosteroid injections. Methods patients with primary anterior shoulder pain precisely reproduced by deep pressure on the apex of the coracoid process were recruited. Patients with clinical or instrumental signs of other shoulder disorders were excluded. Patients were given an injection of triamcinolone acetonide 40 mg/ml 1 ml at the coracoid trigger point. They were evaluated after 15, 30 and 60 days and at 2 years using Equal Visual Analog Scale (EQ-VAS) and the Italian version of the Simple Shoulder Test (SST). Results between January 1 and December 31 2010, we treated 15 patients aged 26–66 years. The majority were women (86.67%). At 15 days, 6 (40%) patients reported complete resolution of their symptoms, while 9 (60%) complained of residual symptoms and received another injection. At 30 days, 14 (93.33%) patients were pain-free and very satisfied. At 2 years, the 14 patients who had been asymptomatic at 30 days reported that they had experienced no further pain or impaired shoulder function. The analysis of variance for repeated measures showed a significant effect of time on EQ-VAS and SST scores. Conclusions the present study documents the existence, and characteristics, of a “coracoid syndrome” characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process and showed that the pain is usually amenable to steroid treatment. This syndrome should be clearly distinguished from anterior shoulder pain due to other causes, in

  12. Arthroscopic Findings After Traumatic Shoulder Instability in Patients Older Than 35 Years

    OpenAIRE

    Robinson, Elisabeth C.; Thangamani, Vijay B.; Kuhn, Michael A.; Ross, Glen

    2015-01-01

    Background: Shoulder instability in the older patient traditionally has received less attention in the literature than in the younger patient population. However, when traumatic dislocation does occur, these patients often still have frequent pain, disability, and even continued instability. Purpose: To characterize the pathoanatomy of traumatic anterior shoulder instability in the older patient population and to discuss the correlating symptoms that ultimately led to operative treatment. Stu...

  13. Recurrent anterior shoulder instability: accuracy of estimations of glenoid bone loss with computed tomography is insufficient for therapeutic decision-making

    International Nuclear Information System (INIS)

    To evaluate the reliability of glenoid bone loss estimations based on either axial computed tomography (CT) series or single sagittal (''en face'' to glenoid) CT reconstructions, and to assess their accuracy by comparing with actual CT-based bone loss measurements, in patients with anterior glenohumeral instability. In two separate series of patients diagnosed with recurrent anterior glenohumeral instability, glenoid bone loss was estimated on axial CT series and on the most lateral sagittal (en face) glenoid view by two blinded radiologists. Additionally, in the second series of patients, glenoid defects were measured on sagittal CT reconstructions by an independent observer. In both series, larger defects were estimated when based on sagittal CT images compared to axial views. In the second series, mean measured bone loss was 11.5% (SD = 6.0) of the total original glenoid area, with estimations of 9.6% (SD = 7.2) and 7.8% (SD = 4.2) for sagittal and axial views, respectively. Correlations of defect estimations with actual measurements were fair to poor; glenoid defects tended to be underestimated, especially when based on axial views. CT-based estimations of glenoid bone defects are inaccurate. Especially for axial views, there is a high chance of glenoid defect underestimation. When using glenoid bone loss quantification in therapeutic decision-making, measuring the defect instead of estimating is strongly advised. (orig.)

  14. Systematics of shoulder instability; Systematik der Schulterinstabilitaet

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Maehringer-Kunz, A. [Johannes-Gutenberg-Universitaet Mainz, Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Mainz (Germany)

    2015-03-01

    Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to the causative factors as the pathogenesis of instability plays an important role with respect to treatment options. Instabilities are classified into traumatic and atraumatic instabilities as part of a multidirectional instability syndrome and into microtraumatic instabilities. For diagnostics plain radiographs (''trauma series'') are performed to document shoulder dislocation and its successful repositioning. Direct magnetic resonance (MR) arthrography is the most important imaging modality for delineation of the different injury patterns of the labral-ligamentous complex and bony structures. Monocontrast computed tomography (CT) arthrography with the use of multidetector CT scanners represents an alternative imaging modality; however, MR imaging should be preferred in the work-up of shoulder instabilities due to the mostly younger age of patients. (orig.) [German] Unter einer Schulterinstabilitaet versteht man jede zu Beschwerden fuehrende Translation des Humeruskopfs in Relation zur Gelenkpfanne waehrend einer aktiven Bewegung der Schulter. Glenohumerale Instabilitaeten werden heute nach ihrer Aetiologie eingeteilt, da bei der Wahl der Therapie der Entstehungsmechanismus der Instabilitaet eine wichtige Rolle spielt. Danach unterscheidet man primaer traumatisch von atraumatisch entstandenen Instabilitaeten sowie Mikroinstabilitaeten. Bei der Diagnostik dienen konventionelle Roentgenuebersichtsaufnahmen nur noch zur Dokumentation einer Luxation und zur Beurteilung der Reposition. Die durch eine Instabilitaet hervorgerufenen Verletzungsfolgen am labroligamentaeren Komplex und den knoechernen Strukturen werden heute bevorzugt mit der direkten MR-Arthrographie dargestellt. Hierbei koennen unterschiedliche Verletzungsmuster dargestellt werden. Nach

  15. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    OpenAIRE

    Er, Mehmet Serhan; Eroglu, Mehmet; Erten, Recep Abdullah; Metineren, Hasan; Altinel, Levent

    2015-01-01

    Anterior shoulder dislocations are the most common major joint dislocations encountered in the emergency departments and fractures of proximal humerus can accompany with dislocations. Although the treatment of acute isolated traumatic anterior shoulder dislocation is generally simple, the treatment of neglected fracture-dislocations becomes more complicated. In this report, a 22-year-old male patient who had posttraumatic locked, shoulder fracture-dislocation is presented. Open reduction and ...

  16. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

    Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand). He complained of...

  17. Constrained fixed-fulcrum reverse shoulder arthroplasty improves functional outcome in epileptic patients with recurrent shoulder instability

    Science.gov (United States)

    Thangarajah, Tanujan; Higgs, Deborah; Bayley, J I L; Lambert, Simon M

    2016-01-01

    AIM: To report the results of fixed-fulcrum fully constrained reverse shoulder arthroplasty for the treatment of recurrent shoulder instability in patients with epilepsy. METHODS: A retrospective review was conducted at a single facility. Cases were identified using a computerized database and all clinic notes and operative reports were reviewed. All patients with epilepsy and recurrent shoulder instability were included for study. Between July 2003 and August 2011 five shoulders in five consecutive patients with epilepsy underwent fixed-fulcrum fully constrained reverse shoulder arthroplasty for recurrent anterior shoulder instability. The mean duration of epilepsy in the cohort was 21 years (range, 5-51) and all patients suffered from grand mal seizures. RESULTS: Mean age at the time of surgery was 47 years (range, 32-64). The cohort consisted of four males and one female. Mean follow-up was 4.7 years (range, 4.3-5 years). There were no further episodes of instability, and no further stabilisation or revision procedures were performed. The mean Oxford shoulder instability score improved from 8 preoperatively (range, 5-15) to 30 postoperatively (range, 16-37) (P = 0.015) and the mean subjective shoulder value improved from 20 (range, 0-50) preoperatively to 60 (range, 50-70) postoperatively (P = 0.016). Mean active forward elevation improved from 71° preoperatively (range, 45°-130°) to 100° postoperatively (range, 80°-90°) and mean active external rotation improved from 15° preoperatively (range, 0°-30°) to 40° (20°-70°) postoperatively. No cases of scapular notching or loosening were noted. CONCLUSION: Fixed-fulcrum fully constrained reverse shoulder arthroplasty should be considered for the treatment of recurrent shoulder instability in patients with epilepsy. PMID:27458554

  18. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar C

    2013-01-01

    Full Text Available Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.Case Report: A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted . There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks.Conclusion: Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored.

  19. Audit on necessity of radiographs in anterior shoulder dislocations

    OpenAIRE

    K. Ahmadi, M.D; M. Mofidi, M.D.

    2008-01-01

    AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior should...

  20. Simple self-reduction method for anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2014-01-01

    Conclusion: The presented Boss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial. The successful rate is comparable with other established methods.

  1. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

  2. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    OpenAIRE

    Yashavantha Kumar C; Nalini K B; Lalit Maini; Prashanth Nagaraj

    2013-01-01

    Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislo...

  3. Differential expression of extracellular matrix genes in glenohumeral capsule of shoulder instability patients.

    Science.gov (United States)

    Belangero, Paulo Santoro; Leal, Mariana Ferreira; Figueiredo, Eduardo Antônio; Cohen, Carina; Andreoli, Carlos Vicente; Smith, Marília Cardoso; Pochini, Alberto de Castro; Ejnisman, Benno; Cohen, Moises

    2016-07-01

    Anterior shoulder instability is a common orthopedic problem. After a traumatic shoulder dislocation, patients present a plastic deformation of the capsule. The shoulder instability biology remains poorly understood. We evaluated the expression of genes that encode the cartilage oligomeric matrix protein (COMP), fibronectin 1 (FN1), tenascin C (TNC) and tenascin XB (TNXB) in the glenohumeral capsule of anterior shoulder instability patients and controls. Moreover, we investigated the associations between gene expression and clinical parameters. The gene expression was evaluated by quantitative reverse transcription-polymerase chain reaction in the antero-inferior (macroscopically injured region), antero-superior and posterior regions of the capsule of 29 patients with shoulder instability and 8 controls. COMP expression was reduced and FN1 and TNC expression was increased in the antero-inferior capsule region of cases compared to controls (p shoulder instability patients (p = 0.022). COMP expression was reduced in the antero-inferior region compared to the posterior region of shoulder instability patients (p = 0.007). In the antero-inferior region, FN1 expression was increased in the capsule of patients with more than one year of symptoms (p = 0.003) and with recurrent dislocations (p = 0.004) compared with controls. FN1 and TNXB expression was correlated with the duration of symptoms in the posterior region (p shoulder instability patients. Dislocation episodes modify FN1, TNC and TNXB expression in the injured tissue. COMP altered expression may be associated with capsule integrity after shoulder dislocation, particularly in the macroscopically injured portion. PMID:27093129

  4. A Rare Complication of Tuberculous Meningitis Pediatric Anterior Glenohumeral Instability

    OpenAIRE

    Kerem Bilsel; Mehmet Erdil; Mehmet Elmadag; Ceylan, Hasan H.; Derya Celik; Ibrahim Tuncay

    2012-01-01

    Dislocation and instability of the shoulder joint are rare occurrences in childhood. Traumatic, infectious, congenital, and neuromuscular causes of pediatric recurrent shoulder dislocations are reported before. Central nervous system infection in infancy may be a reason for shoulder instability during childhood. This situation, which causes a disability for children, can be treated successfully with arthroscopic stabilization of the shoulder and postoperative effective rehabilitation protocol...

  5. Endovascular treatment of axillary artery dissection following anterior shoulder dislocation.

    Science.gov (United States)

    Fass, G; Barchiche, M Reda; Lemaitre, J; De Quin, I; Goffin, C; Bricart, R; Bellens, B

    2008-01-01

    Injury to the axillary artery is a rare complication of anterior shoulder dislocation. Open surgical repair is technically demanding because of the anatomical position of the vessel and the propensity for concomitant injuries. Standard surgical exposure techniques involve extensive dissection, including a combination of supraclavicular or infraclavicular incision, median sternotomy, and thoracotomy causing significant morbidity and mortality rates. Endovascular techniques may offer an alternative to these surgically demanding procedures. We present a patient with a traumatic dissection of the axillary artery following anterior shoulder dislocation who was successfully managed with an endovascular stent. PMID:18411587

  6. Simple self-reduction method for anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    Reiner Wirbel; Martin Ruppert; Elmar Schwarz; Bernhard Zapp

    2014-01-01

    Objective:To demonstrate and evaluate a modified simple method about self-reduction of anterior shoulder dislocation for significance in the emergency room. Methods:TheBoss-Holzach-Matter method for self-reduction of anterior shoulder disloaction is described.Patients with an anterior shoulder dislocation were retrospectively analysed concerning age, gender, type of anterior shoulder dislocation, occurrence of associated fractures, time between injury and reduction, reduction time, and method of reduction with its respective success rate. Results:Eighty-six patients(52 men,34 women, mean age49 years) were treated fromJanuary 2010 toJune2014.The reduction time ranged between20 seconds and6 min(mean1.5 min). Subcoracoid type of shoulder dislocation was seen in72 cases(84%), subglenoid type in14 cases(16%).Associated factures were seen in20 cases, proportionally more often in subgleboid dislocations,12 at the greater tuberosity,6 at the inferior rim of the glenoid fossa and2 at both localizations.TheBoss-Holzach-Matter method was used in35 cases with a success rate of 71.5%; dieKocher method and traction/countertraction method with premedication were used in 14 cases and17 cases with success rates of64% and70%, respectively.All other cases and the failed primary attempts required hyponotic medication.All patients older than70(n=16) were not able to perform the self reducing procedure. Conclusion:The presentedBoss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial.The successful rate is comparable with other established methods.

  7. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... the shoulder comes in is a group of muscles behind the shoulder. That group of muscles is known as the scapular stabilizers, and we ... time working very hard to get those shoulder muscles strong so that when that shoulder is in ...

  8. Radiographic evaluation of anterior dislocation of the shoulder

    International Nuclear Information System (INIS)

    To establish radiographic criteria to choose the most appropriate technique of reduction for each type of anterior glenohumeral dislocation, and to determine the type of dislocation which requires general anesthesia. Material and Methods: Radiography in two different projections was performed in 67 patients with antero-inferior shoulder dislocations before a reduction attempt. The method proposed by Boss-Holzach-Matter was used as the primary technique for all shoulder dislocations. Results: Most subcoracoid dislocations (84.4%) could be reduced by the Boss-Holzach-Matter method while only a few subglenoid dislocations (15.8%) were reducible by this technique. Displaced associated fractures significantly reduced the success rate of the reduction attempts. Conclusion: Anterior dislocations of the shoulder require different methods of reduction depending upon the type (sub-group) of dislocation. Reduction of subglenoid dislocations with associated greater tuberosity fracture should be performed under general anesthesia to avoid head-splitting fracture

  9. Double contrast CT arthrographic findings of shoulder instability

    International Nuclear Information System (INIS)

    Glenno-humeral joint is a ball and socket joint. It has the greatest range of movement among all the joints of the body. The greatest range of movement is inevitably accompanied by a considerable loss in stability. Thirty three persons underwent Double Contrast CT arthrography of the shoulder for the evaluation of suspected shoulder derangement. We performed 62 shoulder arthrography(33 abnormal shoulders and 29 normal shoulders) and reviewed their findings retrospectively. They had recurrent shoulder dislocation(30 shoulders) or nonspecific shoulder pain(3 shoulders). Injury of the glenoid labrum was seen in 28 shoulders at double contrast CT arthrography. Among 28 cases of the labral injury, labral detachment was seen in 15 cases, labral tear in 5 cases, and labral erosion in 8 cases. Double contrast CT arthrography also showed Hill-Sachs defection in 20 shoulders. The numbers of type 1, type 2, and type 3 capsulolabral attachment in 33 shoulder instability cases were 10, 16,and 7, respectivity, while, 16, 12, and , 1 in 29 normal controls. Type 2 and 3 are more common in shoulder instability group than normal control group. Operation was done in 18 shoulders. Comparing with operation findings, the sensitivity of double contrast CT arthrography in the detection of Hill-Sachs defect was 100% with the specificity of 71% and the accuracy of 89%. The sensitivity, specificity, and accuracy of double contrast CT arthrography in the detection of labral injury were 94%, 100%, and 95%, respectively. Double contrast CT arthrography is a minimally invasive and highly accurate technique for in the evaluation of glenohumeral instability

  10. Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography

    International Nuclear Information System (INIS)

    Objective. To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. Design and patients. We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. Results. MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). Conclusions. Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality. (orig.). With 4 figs

  11. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... here. This is a pretty restrictive harness that athletes wear. And you can see that it wraps ... stiff shoulder. And a stiff shoulder for an athlete isn't exactly a great thing. So, I ...

  12. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... shoulder – how do you approach those two as far as treatment recommendations and your expectations for success ... it holds the shoulder from going up too far into that risky position, or too far back ...

  13. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... 13:23 Now we're moving into the space between that ball and cup that Joe so… ... glenoid socket for the shoulder. There's a wide space in this boy's shoulder, which is partially due ...

  14. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... that when that shoulder is in that at risk position…The shoulder's pretty darn stable down here ... do this procedure without putting the patient at risk? Is it a question of seeing one, assisting ...

  15. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... So there are two of what we call plastic cannulas that actually go into the shoulder and ... of the shoulder joints we have several different plastic cannulas that we used, as I mentioned, to ...

  16. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... type device that utilizes tiny one quarter inch holes around the shoulder joint in order to tighten ... we're trying to do is establish other holes in the shoulder to actually work through. So ...

  17. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... what we hear in a patient that has disability from an unstable shoulder. And I think we' ... inside of the shoulder joint with quite good visual acuity. We can really tell with great detail ...

  18. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... the glenoid socket for the shoulder. There's a wide space in this boy's shoulder, which is partially ... the cartilage that are torn, but also the wide spaces due to the fact that the ligaments ...

  19. Does surgery for instability of the shoulder truly stabilize the glenohumeral joint?

    Science.gov (United States)

    Lädermann, Alexandre; Denard, Patrick J.; Tirefort, Jérôme; Kolo, Frank C.; Chagué, Sylvain; Cunningham, Grégory; Charbonnier, Caecilia

    2016-01-01

    Abstract Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects glenohumeral translation. The purpose of this prospective clinical study was to analyze the effect of surgical stabilization on glenohumeral translation. Glenohumeral translation was assessed in 11 patients preoperatively and 1 year postoperatively following surgical stabilization for anterior shoulder instability. Translation was measured using optical motion capture and computed tomography. Preoperatively, anterior translation of the affected shoulder was bigger in comparison to the normal contralateral side. Differences were significant for flexion and abduction movements (P shoulders was not significantly different from the preoperative values. While surgical treatment for anterior instability limits the chance of dislocation, it does not seem to restore glenohumeral translation during functional range of motion. Such persistent microinstability may explain residual pain, apprehension, inability to return to activity and even emergence of dislocation arthropathy that is seen in some patients. Further research is necessary to better understand the causes, effects, and treatment of residual microinstability following surgical stabilization of the shoulder. PMID:27495043

  20. Anterior dislocation of shoulder in eclampsia:a case report

    Institute of Scientific and Technical Information of China (English)

    Seema Rawat; Sanjay Meena; Shreesh Kumar Gangari; Lalit Kumar Lohia

    2012-01-01

    This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia.This is an unusual mechanism of injury,but similar to other uncontrolled muscular contractions caused by electroconvulsive therapy,etc.To the best of our knowledge only one such case has been reported in the English literature.Closed reduction under general anaesthesia was successfully achieved.High suspicion in patients complaining of pain over shoulder joint is necessary for early diagnosis of this condition.

  1. New aspects in pathogenesis and therapy of shoulder instability

    OpenAIRE

    Krüger, David Richard

    2015-01-01

    Introduction: Instability of the glenohumeral joint is accompanied by macroscopic changes of the static stabilizers. Not much evidence is available whether these changes can be found on microscopic level and if they are influenced by demographic variables. Conservative and operative therapy options are available for the treatment of shoulder instability. Patients with failed operative shoulder stabilization resemble a special collective in which the value of arthroscopy for revision stabi...

  2. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

    Directory of Open Access Journals (Sweden)

    Amit Mishra

    2012-01-01

    Full Text Available Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 years, were reviewed in the study. The average followup period was 27 months (range 24-36 months. University of California Los Angeles shoulder rating scale was used to determine the outcome after surgery. The recurrence rates, range of motion, as well as postoperative function and return to sporting activities were evaluated. Results : Thirty six patients (72.0% had excellent results, whereas seven patients (14.0% had good results. The mean pre- and postoperative range of external rotation was 80.38° and 75.18°, respectively. Eighty-six percent patients had stability compared with the normal sided shoulder and were able to return to sports. There were no cases of redislocation observed in this study; however, three cases had mild laxity of the joint. Conclusion: Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent postoperative shoulder motion and low recurrence rates.

  3. Audit on necessity of radiographs in anterior shoulder dislocations

    Directory of Open Access Journals (Sweden)

    K. Ahmadi, M.D

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior shoulder dislocation were referred to Hazrat Rasoul Akram and Haftome Tir Hospitals emergency departments in Tehran, and were investigated for a one year period. The emergency physicians evaluated and documented the possibility of dislocation or relocation, before obtaining radiographs. Outcome measures were the assessment of joint positions on the x-rays by an orthopedic surgeon.Results: 84 cases (72% were male and 32 cases (28% were female. Mean age of the patients was 31.5±8.5 yrs. Thirty (30 patients had recurrent dislocations without traumatic mechanism (group 1 and eighty six (86 patients had no prior dislocation or a blunt mechanism of injury (group 2. The accuracy of the emergency physician’s assessment in dislocations was 100% in group 1 and 98% in group 2. False assessments occurred only in patients with fractures. There is no significant difference between emergency physicians and orthopedic surgeons in the assessment of dislocations and relocations, when the emergency physicians did accuralty diagnose them.Conclusion: Our study showed that the physicians are highly accurate in clinical determination of anterior shoulder dislocation and relocation. Pre-reduction films should be obtained when the mechanism of injury is trauma. Post-reduction films should be obtained in fracture-dislocations or when the physicians are uncertain of correct relocation.

  4. Imaging findings in posterior instability of the shoulder

    International Nuclear Information System (INIS)

    Posterior shoulder instability refers to the symptoms and signs resulting from excessive posterior translation of the humerus. Magnetic resonance (MR) imaging is the radiological modality of choice in the diagnostic assessment of posterior instability. Computed tomography (CT) is useful in the evaluation of osseous abnormalities associated with posterior instability. A detailed description of the posterior osseous and labroligamentous abnormalities has evolved recently, and many variant lesions of the posteroinferior labrum and/or capsular structures have been described. As the recommended surgical management of lesions associated with posterior instability is a lesion-specific approach, awareness of the specific lesions that have been described in association with posterior instability helps in pre-surgical planning. The purpose of this article is to review the classification of, and injury mechanisms leading to, posterior shoulder instability and to describe imaging findings associated with posterior instability, with emphasis on MR imaging. (orig.)

  5. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... strength of the shoulder comes in is a group of muscles behind the shoulder. That group of muscles is known as the scapular stabilizers, ... actually, the rotator cuff is one in the group of muscles that we strengthened that give the ...

  6. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... taking down any muscles in front of the shoulder, and I think yielding less pain for the patient pos-top, potentially less scar ... that he had an open shift. Now the shoulder is maybe too tight and leading to pain, but if you could talk about that issue ...

  7. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

    OpenAIRE

    Lützner J; Krummenauer F; Lübke J; Kirschner S; Günther K-P; Bottesi M

    2009-01-01

    Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, ei...

  8. Anterior labral tear: diagnostic value of MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    To assess the accuracy of magnetic resonance(MR) arthrography in the diagnosis of anterior labral tear of the shoulder Between september 1996 and February 2000, MR arthrography of the shoulder was performed in 281 patients with a history of shoulder pain or instability. Among this total, only 157 shoulders in 154 patients who underwent arthroscopy or open surgery 0 to 230 (average, 20.9) days after MR arthrography were included in this study; the subjects comprised of 150 males and 4 females with an average age of 23.3 years. MR arthrographs of these 154 patients were analyzed for the presence of anterior labral tears, and the findings were correlated with the arthroscopic and surgical findings. Anterior labral tear was classified as A to D according to its location, as determined by arthroscopy and surgery. (A=4 to 6 o'clock direction, anteroinferior; B=2 to 4 o'clock direction, central; C=12 to 2 o'clock direction, anterosuperior; D= SLAP lesion). The retrospective analysis of MR arthrographs showing false-positive and negative findings was also underthken.. In the diagnosis of anterior labral tear, MR arthrography showed a sensitivity of 94%, a specificity of 90% and an accuracy of 91%. Anterior labral tears were confirmed by arthroscopy or surgery in 62 of the 157 shoulders (39%). Among 62 lesion, two (3%) were observed in area A, 32(52%) in area A+B, nine (15%) in area A+B+C, one(2%) in area A+B+D,13(21%) in area A+B+C+D, two (3%) in area B+C, one(2%) in area B+D, and two(3%) in area C. Among ten false-positive cases, seven were focal lessions (two, three and two lesions in area A, B and C, respectively), and in the remaining three cases, lacated in area A+B, MR arthrography revealed thickening and deformation. All four false negatives were focal lesions (two in area A and two in area C). Other than in focal lesions, in which accuracy was relatively low, MR arthrography showed high sensitivity, specificity and accuracy in the diagnosis of anterior labral tear

  9. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... through the shoulder joint in order to, one, clean it out, but also just to keep it ... you can see we're going to gently clean back some of the excess cartilage there. Try ...

  10. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... that kid's going to have arthritis in the future. It's a surgery that's done to change a ... of my goals, in the not too distant future, is to work on a shoulder dislocation prevention ...

  11. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... inside of the shoulder joint with quite good visual acuity. We can really tell with great detail ... that suture anchor. You can see I can control how tight it is by, number one, where ...

  12. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... lead to shoulder ligaments that were loose to self-tighten? So, can therapy…can strengthening the cuff ... the future. It's a surgery that's done to change a lifestyle. So if the patient wants to ...

  13. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... and the people who are sitting at home right now watching it's difficult for them to understand. ... an incision over the front of their shoulder, right there, that measures about five inches in length. ...

  14. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... the false sense the shoulder's perfectly fine and return too soon. So, they're held out for ... Is the person going to be able to return to their sport? And we have to realistically ...

  15. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... 34:32 MEAGAN: At first I started doing gravity assisted exercises like Codman's which are…I laid ... hang off and just did circles with the gravity taking my shoulder, just to gain some of ...

  16. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... there. And as you'll see, there's constantly water being pushed through the shoulder joint. Most of ... a bit here, so it's a very tight space. And even getting three sutures in there is ...

  17. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... the young girl who says, you know, over time my shoulder just starts to feel loose and ... where it just slowly starts to develop over time, that kid needs extensive physical therapy, because most ...

  18. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... stronger; often four, six, eight weeks of a strengthening program for those muscles behind the shoulder to support ... a harness type brace may, along with a strengthening program, help to try to keep that ball back ...

  19. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... the tear, the dislocation injury, they have a real loss of motion. They have a lot of ... to rehabilitate, to strengthen the shoulder. And the real key part of where the strength of the ...

  20. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... Meagan. I mean, she's pretty much of a dream because she in herself is an athletic trainer ... are more forceful. There's more energy placed, more stress placed across that shoulder joint. And I know ...

  1. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... for perhaps some other things you do in life a stiff shoulder isn't so bad. But ... were interested in getting me back to normal life. I wouldn't go to anyplace different. I ...

  2. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... that comes under a lot of load and stress to it and is injured not infrequently. The ... are more forceful. There's more energy placed, more stress placed across that shoulder joint. And I know ...

  3. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... of how we first approach that. 00:02:42 JOE CONGENI, MD: Yeah. The shoulder's a really ... capsule. JOE CONGENI, MD: Um hmm. 00:04:42 KERWYN JONES, MD: It's a tough concept to ...

  4. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... there. And as you'll see, there's constantly water being pushed through the shoulder joint. Most of ... care. And the lastly, we can complete the cycle as we saw with Meagan, with really state ...

  5. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... By strengthening the rotator cuff muscles can this lead to shoulder ligaments that were loose to self- ... patient and her experience. And it's going to lead well into what we've had a lot ...

  6. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... weeks of time trying to get that shoulder stronger; often four, six, eight weeks of a strengthening ... suture anchor? And which do you feel is stronger? I think this is a good time as ...

  7. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... that comes under a lot of load and stress to it and is injured not infrequently. The way the joint ... there's constantly water being pushed through the shoulder joint. Most of ...

  8. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... of get some of their competitiveness and their energy into the rehabilitation and then a lot of ... JOE CONGENI, MD: ---are more forceful. There's more energy placed, more stress placed across that shoulder joint. ...

  9. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... shoulder. The rest of the device, including the metal and the plastic tip there will come out. ... patient's body over time. Some people would use metal suture anchors, which work just as well. 00: ...

  10. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... made, it's kind of a…you know, we call it a ball and socket joint, but it's ... the cup, or the socket; what we commonly call the glenoid socket for the shoulder. There's a ...

  11. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... in just getting their motion back and their function back in the shoulder to some extent. But, ... and we work strength. And then we work function. And when we get to that functional stage, ...

  12. The external rotation method for reduction of acute anterior shoulder dislocations

    OpenAIRE

    Marinelli, Mario; de Palma, Luigi

    2009-01-01

    Background Shoulder dislocations account for almost 50% of all joint dislocations, and are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the external rotation method (ERM) in the reduction of acute anterior shoulder dislocation. Materials and methods Between August 2006 and April 2007, ERM was applied to 31 patients who presented with traumatic anterior shoulder dislocation to the Emergency Department of our Ho...

  13. Bilateral Anterior Shoulder Dislocation with Symmetrical Greater Tuberosity Fracture following Seizure

    OpenAIRE

    Suryavanshi, Ashish; Mittal, Amber; Dongre, Snehal; Kashyap, Neeti

    2012-01-01

    Introduction: Majority of bilateral shoulder dislocations are posterior. Simultaneous bilateral anterior shoulder dislocations and bilateral anterior fracture-dislocations are rare and mostly of traumatic origin. We present a rare case of bilateral anterior shoulder dislocation with symmetrical greater tuberosity fracture following an episode of seizure with an unusual injury mechanism which was treated conservatively. Case Report: A 45 year old office worker presented to the Casualty of our ...

  14. Concurrent cases of bilateral anterior shoulder dislocation: our observations in three cases

    OpenAIRE

    Orhan Akinci; Yavuz Akalin; Ali Otuzbir; Alpaslan Oztürk

    2016-01-01

    Bilateral anterior shoulder dislocations are  rarely seen and usually occur due to the same mechanism arising from traumatic injuries. In here, we discussed three cases of traumatic bilateral anterior shoulder dislocation , one had an additional patella fracture, and the other one had bilateral tuberculum majus fracture. All of the patients were female and our first case that presented here was 65-year-old and given a closed reduction for isolated bilateral anterior shoulder dislocation that ...

  15. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... CONGENI, MD: Yeah. The shoulder's a really unique joint. And so in sports it's a joint that comes under a lot of load and ... and is injured not infrequently. The way the joint is made, it's kind of a…you know, ...

  16. Bankart Repair to Correct Shoulder Instability

    Science.gov (United States)

    ... very excellent conservative care, non-operative care for sports injuries, shoulder injuries. If necessary, we can communicate with ... to get you through from the day of injury to that six or nine month point post-op where you're ready to get back to your sport. 00:50:07 This webcast will be archived ...

  17. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... very excellent conservative care, non-operative care for sports injuries, shoulder injuries. If necessary, we can communicate with ... to get you through from the day of injury to that six or nine month point post-op where you're ready to get back to your sport. 00:50:07 This webcast will be archived ...

  18. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... the shoulder pops out of place from an injury. Oftentimes those kids may fail physical therapy and end up requiring surgery. 00:06:19 ... we know that the patient with the traumatic injury, that had a dislocation that ... first with physical therapy and rehab. So, Joe, maybe if you could ...

  19. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... future, is to work on a shoulder dislocation prevention program. 00:46:35 TODD RITZMAN, MD: Sure. That's a good point. I think when talking about new things in the frontier, also maybe could you comment on after the injury occurs some of the new things that are ...

  20. Anterior humeral circumflex artery avulsion with brachial plexus injury following an isolated traumatic anterior shoulder dislocation.

    Science.gov (United States)

    Shah, Rohi; Koris, Jacob; Wazir, Akhlaq; Srinivasan, Shyamsundar S

    2016-01-01

    A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay. PMID:26969353

  1. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation

    Directory of Open Access Journals (Sweden)

    Riccardo D′Ambrosi

    2015-01-01

    Full Text Available This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process.

  2. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department

    OpenAIRE

    Baykal, B; Sener, S; Turkan, H

    2005-01-01

    Background: Shoulder dislocations account for almost 50% of all joint dislocations, which are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the scapular manipulation technique (SMT) to reduce traumatic anterior shoulder dislocations.

  3. Posttraumatic persistent shoulder pain: Superior labrum anterior-posterior (SLAP) lesions

    OpenAIRE

    Gulacti, Umut; Can, Cagdas; Erdogan, Mehmet Ozgur; Lok, Ugur; Buyukaslan, Hasan

    2013-01-01

    Patient: Male, 57 Final Diagnosis: Typ 2 Superior labrum anterior-posterior lesion Symptoms: Shoulder pain after trauma Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology • Emergency Medicine Objective: Rare disease Background: Due to the anatomical and biomechanical characteristics of the shoulder, traumatic soft-tissue lesions are more common than osseous lesions. Superior labrum anterior-posterior (SLAP) lesions are an uncommon a cause of shoulder pain. SLAP is inj...

  4. A Case of Neglected Bilateral Anterior Shoulder Dislocation: A Rare Entity with Unusual Mechanism of Injury

    OpenAIRE

    Raghuram Choulapalle; Ramu Chokkarapu; Ravi Kanth Kolluri; Sreedhar Reddy Anne; Shanmuga Raju Perumal; Pavan Kumar Avadhanam; Ramesh Bheemanathuni

    2015-01-01

    Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury; both hands of the patient were pulled from either side. To the best of our knowledge, this unusual ...

  5. Multi-slice CT evaluation of glenoid bone loss in patients with recurrent anterior shoulder dislocation

    International Nuclear Information System (INIS)

    Objective: To evaluate multi-slice CT (MSCT) in glenoid bone loss of patients with recurrent anterior shoulder dislocation. Methods: MSCT findings of 108 patients with recurrent anterior shoulder dislocation and 12 with single anterior shoulder dislocation were retrospectively studied. The incidence, degrees and locations of glenoid bone losses were recorded. The incidence was analyzed with Fisher exact test. The maximum length,depth and proportion were compared with Wilcoxon rank sum test. Results: Glenoid bone loss was detected in 91.7% (99/108) patients with recurrent anterior shoulder dislocation. The proportion of glenoid bone loss was (16.0 ± 6.0)%, and the central locations of glenoid bone loss were from 2: 20 to 4: 25 (mean 3: 20). Sixty-two percent (67/108) patients had bony Bankart lesions in which 58.2% (39/67) bony fragments were free and 41.8% (28/67) were adherent to the anterior border of the glenoid cavity. Seventy-five percent (9/12) patients with single shoulder dislocation had anterior glenoid bone loss,and the proportion of glenoid bone loss was (15.2 ± 7.1)%. There were no statistical differences of the incidence (P=0.100) and proportion of glenoid bone loss (P=0.453) between the recurrent and single anterior shoulder dislocation. Conclusions: Anterior glenoid bone loss is common in patients with recurrent anterior shoulder dislocation. (authors)

  6. Neglected Anterior Dislocation of Shoulder: is surgery necessary? A Rare Case with review of literature

    OpenAIRE

    Shah, Kunal; Ubale, Tushar; Ugrappa, Harish; Pilankar, Samir; Bhaskar, Atul; Kale, Satishchandra

    2015-01-01

    Introduction: Shoulder joint is the most frequently dislocated joint. However, it is rarely neglected and treatment is sought immediately. Delayed or neglected shoulder dislocations are difficult to manage and require extensive procedures to obtain good functional outcome. Very few cases are described in literature showing neglected shoulder dislocation with good functional range of movement. We report a case with 3 years of neglected anterior shoulder dislocation with preserved joint functio...

  7. Simultaneous Bilateral Anterior Shoulder Dislocation Occurred During Sleepwalking

    Directory of Open Access Journals (Sweden)

    fevzi yilmaz

    2013-10-01

    A 17-years-old male presented to our emergency department with a complaint of bilateral shoulder pain and motion restriction. His past medical history was unremarkable for epilepsy or major trauma. His family members said that he was a sleepwalker since he was 5 or 6 years old and sometimes he was going to another place from his bed and when they saw him there were abrasions especially on his face and extremities. It was learned that he left the drugs given by the doctors for his complaint after using a short time. On his physical examination in the emergency department he appeared to be good, he was concious, cooperative and oriented to person, time and place. His vital signs and neurological examination were normal. His extremity examination revealed that his arms were slightly in abduction and external rotation. There was epaulet sign bilateral on his shoulders and his peripheral neurological examination was otherwise normal. The radiological evaluation revealed bilateral subchorocoidal anterior dislocation without signs of fracture (Figure 1.

  8. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    OpenAIRE

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic...

  9. BILATERAL ANTERIOR DISLOCATION OF SHOULDER WITH GREATER TUBEROSITY FRACTURE DUE TO HYPONATREMIA : A RARE PRESENTATION

    Directory of Open Access Journals (Sweden)

    Sivananda

    2015-01-01

    Full Text Available We here report a rare presentation of bilateral anterior dislocation of shoulder with associated fracture of greater tuberosity in a 38 year old male due to minor trauma which he sustained secondary to hyponatremia induced irritability. There was no associ ated rotator cuff tear which is often associated with BADS which makes this presentation unique. Unilateral dislocation of shoulder is a common condition which is frequently encountered in emergency trauma department. Anterior dislocation is more common th an posterior dislocation. However, simultaneous bilateral shoulder dislocations are usually posterior. Bilateral anterior dislocations with fractures of the greater tuberosity are even rarer and are usually associated with trauma or seizures

  10. The anterior tilt of the acromion: radiographic evaluation and correlation with shoulder diseases

    Energy Technology Data Exchange (ETDEWEB)

    Prato, N.; Peloso, D.; Franconeri, A. [Department of Radiology, San Carlo Hospital, Genoa (Italy); Tegaldo, G. [Dept. of Orthopaedic Surgery, San Carlo Hospital, Genoa (Italy); Ravera, G.B. [Inst. of Medical Statistics and Biometry, University of Genoa (Italy); Silvestri, E.; Derchi, L.E. [Inst. of Radiology, University of Genoa (Italy)

    1998-12-01

    The aim of this study was to test whether the anterior tilt of the acromion can be objectively evaluated on lateral radiographs, and whether there is a relation between this anatomical feature and the most common shoulder diseases. Lateral radiographs of 15 dried scapulas were performed in neutral position and with 5 of caudal, cranial, anterior and posterior angulations. Two hundred and forty-three shoulders, both asymptomatic and affected by chronic and post-traumatic impingement, calcific tendinitis and instability, were examined by conventional radiography. The presence of rotator-cuff tears was investigated by sonography. A method was elaborated to obtain reproducible lateral radiographs and to determine the acromial tilt angle. Inter- and intraobserver and inter- and intraoperator variations in measurements were evaluated. Variations in tube angulation produced changes in tilt-angle values on dried scapulas. The average tilt angle for the chronic impingement and the instability groups were significantly different from the post-traumatic, calcific tendinitis and control groups. Rotator-cuff tears were significantly more frequent in the chronic impingement group and related to a more acute tilt angle. The inter- and intraobserver variability coefficients were 0.95 and 0.98, whereas the inter- and intraoperator variability coefficients were 0.94 and 0.96, respectively. Conventional radiography using fluoroscopy for positioning is a well-reproducible method for the evaluation of acromial tilt. There is a significant difference in tilt-angle values between some groups of subjects examined, but the lack of specificity limits the clinical importance of such measurement. (orig.) With 6 figs., 3 tabs., 34 refs.

  11. The anterior tilt of the acromion: radiographic evaluation and correlation with shoulder diseases

    International Nuclear Information System (INIS)

    The aim of this study was to test whether the anterior tilt of the acromion can be objectively evaluated on lateral radiographs, and whether there is a relation between this anatomical feature and the most common shoulder diseases. Lateral radiographs of 15 dried scapulas were performed in neutral position and with 5 of caudal, cranial, anterior and posterior angulations. Two hundred and forty-three shoulders, both asymptomatic and affected by chronic and post-traumatic impingement, calcific tendinitis and instability, were examined by conventional radiography. The presence of rotator-cuff tears was investigated by sonography. A method was elaborated to obtain reproducible lateral radiographs and to determine the acromial tilt angle. Inter- and intraobserver and inter- and intraoperator variations in measurements were evaluated. Variations in tube angulation produced changes in tilt-angle values on dried scapulas. The average tilt angle for the chronic impingement and the instability groups were significantly different from the post-traumatic, calcific tendinitis and control groups. Rotator-cuff tears were significantly more frequent in the chronic impingement group and related to a more acute tilt angle. The inter- and intraobserver variability coefficients were 0.95 and 0.98, whereas the inter- and intraoperator variability coefficients were 0.94 and 0.96, respectively. Conventional radiography using fluoroscopy for positioning is a well-reproducible method for the evaluation of acromial tilt. There is a significant difference in tilt-angle values between some groups of subjects examined, but the lack of specificity limits the clinical importance of such measurement. (orig.)

  12. Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem.

    Science.gov (United States)

    Martin, Alexander Nicholas; Tsekes, Dimitris; White, William James; Rossouw, Dan

    2016-01-01

    Bilateral anterior shoulder dislocation is a rare clinical entity with few case reports and limited series published in the literature. Bilateral shoulder dislocations are rare and of them, most are posterior. We present a highly unusual case of bilateral, atraumatic, anterior shoulder dislocation with concomitant comminuted greater tuberosity fracture on the right side, secondary to seizure, in a patient without known epilepsy, induced by oral chloroquine medication. We demonstrate the treatment approach that led to a satisfactory clinical outcome, evidenced by radiological union, clinical assessment and Patient Reported Outcome Measure data, following non-operative management of both shoulders. The unusual mechanism for anterior shoulder dislocation, the asymmetric dislocation pattern and peculiar precipitant for the causative seizure all provide interesting learning points from this case. PMID:27005796

  13. ASSESSMENT OF THE RESULTS FROM ARTHROSCOPIC SURGICAL TREATMENT FOR TRAUMATIC ANTERIOR SHOULDER DISLOCATION: FIRST EPISODE

    OpenAIRE

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Botelho, Vinicius; Duarte, Clodoaldo; Checchia, Sergio Luiz

    2015-01-01

    Objective: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. Methods: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93%) were male and one (7%) was female; their ages ranged from 17 to 41 years, with a mean of 28 years. All of the patients evaluated were regul...

  14. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    OpenAIRE

    Tripathy Sujit Kumar; Sen Ramesh Kumar; Aggarwal Sameer; Dhatt Sarvdeep Singh; Tahasildar Naveen

    2012-01-01

    【Abstract】Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective grou...

  15. Neurovascular complications due to the Hippocrates method for reducing anterior shoulder dislocations

    OpenAIRE

    Regauer, Markus; Polzer, Hans; Mutschler, Wolf

    2014-01-01

    In spite of the fact that the Hippocrates method hardly has been evaluated in a scientific manner and numerous associated iatrogenic complications have been reported, this method remains to be one of the most common techniques for reducing anterior shoulder dislocations. We report the case of a 69-year-old farmer under coumarin anticoagulant therapy who sustained acute first time anterior dislocation of his dominant right shoulder. By using the Hippocrates method with the patient under genera...

  16. Bilateral Anterior Fracture-Dislocation of Shoulder Joint- A rare case with Delayed Presentation

    OpenAIRE

    Sunku, Nithin; Kalaiah, Kiran; Marulasidappa, G.; Gopinath, P

    2012-01-01

    Introduction: The shoulder is the most frequently dislocated joint. Bilateral glenohumeral dislocations are rare and almost always posterior. Bilateral anterior fracture dislocations of humeral neck in a patient with seizure are extremely rare. We report one such case of delayed presentation of bilateral anterior fracture dislocation of shoulder after an epileptic attack. Case Report: We describe a rare case of 30 year old gentleman who presented with first episode of seizure following alcoho...

  17. Diagnosis of shoulder instability in dogs and cats: a retrospective study

    International Nuclear Information System (INIS)

    The glenohumeral joint is a remarkable articulation providing the greatest range of motion of any joint in the body. Glenohumeral stabilityresults from several mechanisms, including those that do not require expenditure of energy by muscle ('''passive mechanisms'') and those that do (''active mechanisms''). Glenohumeral instability has been recognized in 47 shoulders of 45 dogs and one cat. Cases are presented because of chronic foreleg lameness. Shoulder joint pain is obviated by theorthopedic examination. Only 57% of the involved shoulders presented with degenerative joint disease. Signs of instability are recognized under anesthesia using a craniocaudal or mediolateral drawer sign or both. This report describes the radiographic and arthroscopic findings of shoulder instability. Arthroscopy of the shoulder joint allows identification of all intra-articular pathologies. Shoulder instability notfully recognized in the past, appears to be the most common cause of shoulder lameness in the dog

  18. An Evaluation of the Responsiveness and Discriminant Validity of Shoulder Questionnaires among Patients Receiving Surgical Correction of Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Kyle A. R. Kemp

    2012-01-01

    Full Text Available Health-related quality-of-life (HRQL measures must detect clinically important changes over time and between different patient subgroups. Forty-three patients (32 M, 13 F; mean age  =  26.00  ±  8.19 years undergoing arthroscopic Bankart repair completed three validated shoulder questionnaires (Western Ontario Shoulder Instability index (WOSI, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment form (ASES, Constant score preoperatively, and at 6, 12, and 24 months postoperatively. Responsiveness and discriminant validity was assessed between those with a satisfactory outcome and those with (1 a major recurrence of instability, (2 a single episode of subluxation, (3 any postoperative episode of instability. Eight (20% patients reported recurrent instability. Compared to baseline, the WOSI detected improvement at the 6- (P<0.001 and 12-month (P=0.011 evaluations. The ASES showed improvement at 6 months (P=0.003, while the Constant score did not report significant improvement until 12 months postoperatively (P=0.001. Only the WOSI detected differential shoulder function related to shoulder instability. Those experiencing even a single episode of subluxation reported a 10% drop in their WOSI score, attaining the previously established minimal clinically important difference (MCID. Those experiencing a frank dislocation or multiple episodes of subluxation reported a 20% decline. The WOSI allows better discrimination of the severity of postoperative instability symptoms following arthroscopic Bankart repair.

  19. An Evaluation of the Responsiveness and Discriminant Validity of Shoulder Questionnaires among Patients Receiving Surgical Correction of Shoulder Instability

    Science.gov (United States)

    Kemp, Kyle A. R.; Sheps, David M.; Beaupre, Lauren A.; Styles-Tripp, Fiona; Luciak-Corea, Charlene; Balyk, Robert

    2012-01-01

    Health-related quality-of-life (HRQL) measures must detect clinically important changes over time and between different patient subgroups. Forty-three patients (32 M, 13 F; mean age  =  26.00  ±  8.19 years) undergoing arthroscopic Bankart repair completed three validated shoulder questionnaires (Western Ontario Shoulder Instability index (WOSI), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment form (ASES), Constant score) preoperatively, and at 6, 12, and 24 months postoperatively. Responsiveness and discriminant validity was assessed between those with a satisfactory outcome and those with (1) a major recurrence of instability, (2) a single episode of subluxation, (3) any postoperative episode of instability. Eight (20%) patients reported recurrent instability. Compared to baseline, the WOSI detected improvement at the 6- (P < 0.001) and 12-month (P = 0.011) evaluations. The ASES showed improvement at 6 months (P = 0.003), while the Constant score did not report significant improvement until 12 months postoperatively (P = 0.001). Only the WOSI detected differential shoulder function related to shoulder instability. Those experiencing even a single episode of subluxation reported a 10% drop in their WOSI score, attaining the previously established minimal clinically important difference (MCID). Those experiencing a frank dislocation or multiple episodes of subluxation reported a 20% decline. The WOSI allows better discrimination of the severity of postoperative instability symptoms following arthroscopic Bankart repair. PMID:23002386

  20. A Case of Neglected Bilateral Anterior Shoulder Dislocation: A Rare Entity with Unusual Mechanism of Injury

    Directory of Open Access Journals (Sweden)

    Raghuram Choulapalle

    2015-01-01

    Full Text Available Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury; both hands of the patient were pulled from either side. To the best of our knowledge, this unusual mechanism of injury has not been reported in the literature.

  1. A new autoreduction method for anterior shoulder dislocation: the GONAIS method.

    Science.gov (United States)

    Gonai, Shiro; Kamio, Yoshito; Matsuoka, Tomoyuki; Harunari, Manabu; Saito, Yutaka; Takuma, Kiyotsugu

    2016-01-01

    Although techniques for autoreduction of anterior shoulder dislocation have been developed, no reports have detailed an autoreduction method using the zero position and traction on the affected arm. Therefore, we developed a new autoreduction technique using the zero position and gentle autotraction. The objective of this study is to present our experience with a new method for autoreduction of anterior shoulder dislocation called the GONAIS (a backronym for “Grasp a waist-high object, Opposite arm assists, Nonsedated, Autoreduction/autotraction, Immobilize the grasped object, and Squatting and stooping”) method. A 41-year-old healthy woman with a history of left shoulder dislocation presented to the emergency department with left shoulder pain while attaching her seatbelt. The X-ray examination revealed subcoracoid dislocation of the left shoulder. The patient tried the GONAIS method after simple guidance and demonstration. Although she felt pain once when weakening traction, she achieved autoreduction successfully in only 2 min and 50 s. Clinical examination after autoreduction revealed normal neurovascular findings and appearance of the shoulder. The X-ray revealed glenohumeral joint reduction and no fracture. Here, our patient using the GONAIS method achieved shoulder autoreduction in a short time. The GONAIS method does not require lying down or sitting on the ground, does not necessarily require the opposite arm, and is minimally invasive. This method would likely be helpful for those who cannot quickly reach a hospital for treatment of anterior shoulder dislocation. PMID:26168697

  2. Bilateral anterior shoulder fracture-dislocation : A case report and a review of the literature

    OpenAIRE

    Dinopoulos, H. T.; Giannoudis, P. V.; Smith, R. M.; Matthews, S.J.

    1999-01-01

     We report an unusual case of bilateral anterior shoulder dislocation following trauma. Previously reported cases were either of bilateral dislocations or bilateral fracture dislocations. In our case the patient suffered bilateral anterior dislocation with a three part fracture dislocation on the right. A review of the literature is presented.

  3. Anterior approach v. posterior approach - ultrasound-guided shoulder arthrogram injection

    Directory of Open Access Journals (Sweden)

    Merle Neethling-du Toit

    2008-11-01

    Full Text Available Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are much quicker and seemingly less painful. In our knowledge it is thus far better to perform anterior approach shoulder arthrogram injections than posterior approach injections

  4. The results of arthroscopic anterior stabilisation of the shoulder using the bioknotless anchor system

    Directory of Open Access Journals (Sweden)

    Cooke Stephen J

    2009-01-01

    Full Text Available Abstract Background Shoulder instability is a common condition, particularly affecting a young, active population. Open capsulolabral repair is effective in the majority of cases, however arthroscopic techniques, particularly using suture anchors, are being used with increasing success. Methods 15 patients with shoulder instability were operated on by a single surgeon (VK using BioKnotless anchors (DePuy Mitek, Raynham, MA. The average length of follow-up was 21 months (17 to 31 with none lost to follow-up. Constant scores in both arms, patient satisfaction, activity levels and recurrence of instability was recorded. Results 80% of patients were satisfied with their surgery. 1 patient suffered a further dislocation and another had recurrent symptomatic instability. The average constant score returned to 84% of that measured in the opposite (unaffected shoulder. There were no specific post-operative complications encountered. Conclusion In terms of recurrence of symptoms, our results show success rates comparable to other methods of shoulder stabilisation. This technique is safe and surgeons familiar with shoulder arthroscopy will not encounter a steep learning curve. Shoulder function at approximately 2 years post repair was good or excellent in the majority of patients and it was observed that patient satisfaction was correlated more with return to usual activities than recurrence of symptoms.

  5. BILATERAL ANTERIOR DISLOCATION OF SHOULDER WITH GREATER TUBEROSITY FRACTURE DUE TO HYPONATREMIA : A RARE PRESENTATION

    OpenAIRE

    Sivananda; Sudheer; Varun Kumar; Mani Kumar

    2015-01-01

    We here report a rare presentation of bilateral anterior dislocation of shoulder with associated fracture of greater tuberosity in a 38 year old male due to minor trauma which he sustained secondary to hyponatremia induced irritability. There was no associ ated rotator cuff tear which is often associated with BADS which makes this presentation unique. Unilateral dislocation of shoulder is a common condition which is frequently encountered in emergency trauma department. Ante...

  6. Comparison of four different reduction methods for anterior dislocation of the shoulder

    OpenAIRE

    Guler, Olcay; Ekinci, Safak; Akyildiz, Faruk; Tirmik, Uzeyir; Cakmak, Selami; Ugras, Akin; Piskin, Ahmet; Mahirogullari, Mahir

    2015-01-01

    Background Shoulder dislocations account for almost 50 % of all major joint dislocations and are mainly anterior. Objective The aim is a comparative retrospective study of different reduction maneuvers without anesthesia to reduce the dislocated shoulder. Methods Patients were treated with different reduction maneuvers, including various forms of traction and external rotation, in the emergency departments of four training hospitals between 2009 and 2012. Each of the four hospitals had differ...

  7. The surgical treatment of the recurrent dislocation on the shoulder joint with minimum invasion anterior approach

    OpenAIRE

    Ninković Srđan; Stanković Milan; Savić Dragan; Matijević Radmila; Milankov Miroslav

    2008-01-01

    Shoulder joint is one of the spherical joints and one of the most movable but also the most unstable joint of locomotive apparatus. The aims of this work are to review and analyze the results of medical treatment of frontal recurrent dislocations on the shoulder with open surgery technique on the Clinic for Orthopaedic Surgery and Traumatology in Novi Sad in the period from 2002 to 2005. Twenty one patients with anterior recurrent dislocations of the shoulder were operated on, 19 men and 2 wo...

  8. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Tripathy Sujit Kumar

    2012-02-01

    Full Text Available 【Abstract】Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had sa-tisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment. An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature. Key words: Shoulder dislocation; Epilepsy; Accidents, traffic

  9. The Milch technique for reduction of anterior shoulder dislocations in an accident and emergency department.

    OpenAIRE

    Johnson, G; Hulse, W; Mcgowan, A.

    1992-01-01

    Following the introduction of the Milch technique as the preferred method of reduction of anterior shoulder dislocations in an A&E department, a retrospective study of the technique was carried out. A total of 187 patients with anterior shoulder dislocations were included. The Milch technique was attempted in 142 cases with a success rate of 86%. There was no statistical difference in the success rates of junior and senior staff. In 73% of the Milch cases either no analgesia or sedation or En...

  10. Shoulder MRI scan

    Science.gov (United States)

    ... finding on an x-ray or bone scan Shoulder pain and fever Decreased motion of the shoulder joint ... of the shoulder joint Shoulder instability Shoulder weakness Shoulder pain and a history of cancer Shoulder pain that ...

  11. Fluoroscopically-Guided Posterior Approach for Shoulder Magnetic Resonance Arthrography: Comparison with Conventional Anterior Approach

    International Nuclear Information System (INIS)

    To prospectively evaluate the usefulness of the fluoroscopically-guided posterior approach compared with the anterior approach for shoulder magnetic resonance(MR) arthrography. Institutional review board approval and informed consent were obtained. Among 60 shoulder MR arthrographies performed on 59 patients with symptomatic shoulders, an intra-articular injection was performed (30 cases using the anterior approach and 30 using the posterior approach). Procedure-related pain was assessed by using a 5 score visual analogue scale (VAS). Depth of the puncture and standardized depth of puncture by body mass index (BMI) were recorded. The contrast leakage along the course of the puncture was evaluated by reviewing the MR. The statistical analyses included the Mann-Whitney U and Kruskal-Wallis test. There was no significant difference in VAS scores between the anterior and posterior groups (1.77 ± 1.10 vs. 1.80 ± 0.96). Depth of puncture and standardized depth of puncture by BMI were significantly shorter in the posterior group than those in the anterior group (4.4 ± 0.8 cm and 1.8 ± 0.3 cm vs. 6.6 ± 0.9 cm and 2.8 ± 0.4 cm, p < 0.001), respectively. The incidence of contrast leakage was more frequent in the posterior group (p = 0.003). The posterior approach will be useful in shoulder MR arthrography with a suspected anterior pathology, a postoperative follow-up study or obese patient.

  12. Determination of prevalence of glenoid bony lesions after recurrent anterior shoulder dislocation using the 3-D CT scan

    OpenAIRE

    Guity, Mohamad Reza; Akhlaghpour, Shaharam; Yousefian, Reza

    2014-01-01

    Background: Glenoid bone damages consisting of anterior rim erosion and bony avulsion are very important in decision making for treatment of recurrent dislocation in shoulder joint. This study was aimed to determine the prevalence of these damages in patients with anterior recurrent shoulder dislocation. Methods: The study was a cross-sectional study evaluating patients with unstable shoulder joint. Glenoid bone damage was assessed using three dimensional (CT) scan implementing either glenoid...

  13. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Sujit Kumar Tripathy; Ramesh Kumar Sen; Sameer Aggarwal; Sarvdeep Singh Dhatt; Naveen Tahasildar

    2011-01-01

    Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment.An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.

  14. Remifentanil versus Fentanyl/Midazolam in Painless Reduction of Anterior Shoulder Dislocation; a Randomized Clinical Trial

    Science.gov (United States)

    Gharavifard, Mohammad; Tafakori, Azadeh; Zamani Moghadam, Hamid

    2016-01-01

    Introduction: Performance of painful diagnostic and therapeutic procedures is common in emergency department (ED), and procedural sedation and analgesia (PSA) is a fundamental skill for every emergency physician. This study was aim to compare the efficacy of remifentanil with fentanyl/midazolam in painless reduction of anterior shoulder dislocation. Method: In this randomized, double blind, clinical trial the procedural characteristics, patients’ satisfaction as well as adverse events were compared between fentanyl/midazolam and remifentanil for PSA of 18–64 years old patients, which were presented to ED following anterior shoulder dislocation. Results: 96 cases were randomly allocated to two groups (86.5% male). There were no significant difference between groups regarding baseline characteristics. Remifentanil group had lower duration of procedure (2.5 ± 1.6 versus 4.6 ± 1.8 minutes, p shoulder dislocation. PMID:27274520

  15. Success outcome of reduction in anterior shoulder dislocation by FARES method

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    Thirunarayanan Vasudevan

    2015-12-01

    Conclusion: Reduction of acute anterior shoulder dislocation by FARES method yields higher success rate in a quick time with less discomfort to the patients and without any complications. [Int J Res Med Sci 2015; 3(12.000: 3858-3862

  16. Involuntary inferior and multidirectional instability of the shoulder: etiology, recognition, and treatment.

    Science.gov (United States)

    Neer, C S

    1985-01-01

    Multidirectional and inferior instability of the shoulder is not rare. Etiological factors include various combinations of (a) repetitive injuries, (b) inherent joint laxity, and (c) one or more major injuries. It is seen in athletic and active patients without generalized joint laxity and as well in sedentary patients with hypermobile joints. Standard operations for unidirectional anterior or posterior dislocations fail to correct multidirectional instability because they do not correct inferior instability and they may displace the head in fixed subluxation to the opposite side leading to severe arthritis ("arthritis of dislocations"). Proper detection depends on suspecting its possibility in all types of patients and in a wide age range as well. Helpful signs include the sulcus sign, positive apprehension test in multiple directions, stress roentgenograms and fluoroscopy, and evaluations under anesthesia. Arthroscopy may be helpful in doubtful cases, but the findings require clinical interpretation. Selection of patients with multidirectional instability for surgery is extremely difficult because it requires not only great care in determining all directions of instability and planning the repair but also determining the motivation of the patient and excluding the possibility of some other condition being present that is causing pain rather than the joint laxity. The results of inferior capsular shift have continued to withstand the test of time and, though it is more difficult than standard procedures, is considered a very helpful procedure in the treatment of these difficult lesions. The principle is to reduce capsular laxity on all three sides by shortening and reinforcing and to reduce the joint volume.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3833944

  17. THE HISTORICAL REVIEW AND TRENDS IN THE DEVELOPMENT OF SURGICAL TREATMENT OF RECCURENT SHOULDER INSTABILITY

    OpenAIRE

    V. M. Prokhorenko; P. V. Filipenko; S. M. Fomenko

    2016-01-01

    An analysis of literature data was conducted to characterize the main current stage of development and formation of diagnosis and treatment of shoulder instability. The purpose of this review was to determine the main directions in the treatment of recurrent shoulder instability and problematic issues that require further scientific research. The main results of patients monitoring that were undergone different types of arthroscopic treatment were presented. The present level of diagnostics a...

  18. Incidence and Characteristics of Traumatic Shoulder Instability in Japanese Military Cadets.

    Science.gov (United States)

    Amako, Masatoshi; Sasao, Hiroshi; Matsuhashi, Yusuke; Yato, Yoshiyuki; Yoshihara, Yasuo; Arino, Hiroshi; Sakurai, Yutaka; Nemoto, Koichi

    2016-06-01

    Little is known regarding the incidence of the shoulder instability in Japan. The aim of this study was to evaluate the incidence of traumatic shoulder instability among Japanese military cadets. A prospective cohort study was performed to capture all traumatic shoulder instability events between 2009 and 2012 among cadets in a military educational academy of the Japan Self Defense Forces. The total number of cadets in the cohort was 5,402 (average age 20.6 years). The incidence of instability events, including dislocation or subluxation, was calculated. Chronicity, demographics of participants, mechanism of injury, and athletic events were also evaluated. The incidence of traumatic dislocation was 4.1/1,000 person-years and that of subluxation was 6.1/1,000 person-years. The incidence of primary dislocation or subluxation was 5.4/1,000 person-years and that of recurrent dislocation or subluxation was 4.7/1,000 person-years. Of first dislocations or subluxations, 92% occurred during sports activities, including after-school sports activities, military training, and gym classes. In conclusion, the overall incidence of shoulder instability events among Japanese military cadets was 10.3/1,000 person-years, and was extremely high. Most shoulder instability events occurred during sports activities, and a program to prevent such injuries during sports activities is necessary for young participants. PMID:27244069

  19. Resultados da cirurgia de latarjet no tratamento da instabilidade anterior traumática do ombro associada à erosão óssea da cavidade glenoidal - seguimento mínimo de um ano Results from latarjet surgery for treating traumatic anterior shoulder instability associated with bone erosion in the glenoid cavity, after minimum follow-up of one year

    Directory of Open Access Journals (Sweden)

    Roberto Yukio Ikemoto

    2011-10-01

    Full Text Available OBJETIVO: Avaliar o resultado da cirurgia de Latarjet para pacientes com luxação recidivante anterior do ombro com perda óssea maior que 25% da cavidade glenoidal. MÉTODO: Avaliamos 26 pacientes submetidos à cirurgia de Latarjet. O tempo médio de seguimento foi de 38 meses e a média etária, de 28 anos. Os pacientes foram avaliados quanto à amplitude de movimento e pelas escalas de Rowe e UCLA, no período pré-operatório como no período pós-operatório, radiografias do ombro para avaliar a presença de artrose, posição e consolidação do enxerto e posicionamento dos parafusos. A análise estatística foi utilizada para avaliar se haveria relação entre o número de episódios de luxação, presença de artrose, correlação entre artrose e limitação da rotação lateral. Comparar a diferença entre o arco de movimento do lado operado com o não acometido e avaliação funcional pré e pós-operatória das escalas de UCLA e Rowe. RESULTADOS: A elevação e rotação lateral foram estatisticamente inferiores do lado operado. A escala de UCLA e a de Rowe mostrou uma melhora estatisticamente significante dos resultados clínico-funcionais (P OBJECTIVE: Evaluate the results from the Latarjet procedure in patients with anterior recurrent dislocation of the shoulder who present bone loss of the glenoid cavity greater than 25%. METHODS: Twenty six male patients underwent the Latarjet procedure, The bone loss was evaluated by means of radiography using the Bernageau view and by means of CAT scan. The patients were evaluated with regard to range of motion, using the Rowe and UCLA scales, before and after the operation, and by radiographs to assess the presence of arthrosis, position and consolidation of the graft and positioning of the screws. Statistical analysis was used to assess whether there was any relationship between the number of episodes of dislocation and the presence of arthrosis, , and any relationship between arthrosis and

  20. Long-Lever-Arm Manipulation Under Anesthesia With Resultant Traumatic Anterior Shoulder Dislocation.

    Science.gov (United States)

    Roubal, Paul J; Placzek, Jeffrey D

    2016-08-01

    The patient was a 61-year-old woman who underwent long-lever manipulation under anesthesia (MUA) for adhesive capsulitis. Two weeks following MUA, the constellation of clinical findings raised concern for possible adverse outcomes. Radiographs were obtained, as well as subsequent magnetic resonance imaging and computed tomography scans. Images revealed anterior shoulder dislocation with Bankart and Hill-Sachs lesions, and an anterior rotator cuff tear. J Orthop Sports Phys Ther 2016;46(8):707. doi:10.2519/jospt.2016.0412. PMID:27477474

  1. Simultaneous anterior dislocation of the shoulder and fracture of the ipsilateral humeral shaft : Two case reports

    OpenAIRE

    Chen, C.-H.; Lai, P.-L.; Niu, C.-C.; Chen, W.-J.; Shih, C.-H.

    1998-01-01

    Two patients with anterior dislocation of the shoulder and ipsilateral fracture of the shaft of the humerus have been studied and the mechanism of their injuries has been documented. Closed reduction of the dislocations was performed under anaesthesia during surgery for humeral fixation with a dynamic compression plate. The fractures and dislocations healed without any problems at 6 to 9 months postoperatively. At recent follow-up, one patient had returned to work and ...

  2. Effect of shoulder flexion angle and exercise resistance on the serratus anterior muscle activity during dynamic hug exercise

    OpenAIRE

    Yoo, Won-Gyu

    2016-01-01

    [Purpose] The primary aim of this study was to determine the effect of shoulder flexion angle and exercise resistance on the serratus anterior muscle during dynamic hug exercise. [Subjects] Ten men aged 22–32 years were recruited. [Methods] The subjects performed dynamic hug exercise at different shoulder flexion angles and under resistance weight conditions. Serratus anterior muscle activities were measured by using the surface electromyographic system during the dynamic hug exercises. After...

  3. Irreducible Anterior Shoulder Dislocation Associated With Displaced Fracture of the Greater Tuberosity: An Analysis of Seven Cases

    Directory of Open Access Journals (Sweden)

    Morteza Nakhaei Amroodi

    2015-11-01

    Full Text Available Background: Although anterior shoulder dislocation is the most prevalent type of body dislocation, irreducible anterior shoulder dislocation is seldom reported in the literature, which is usually due to physical obstacles. Objectives: This study presents our findings regarding the causes of irreducibility of anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Patients and Methods: CT scans, open reduction of the joint, and internal fixation of the tuberosity was performed in seven patients with irreducible anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Results: As confirmed by intraoperative findings, the CT scans showed the cause of irreducible shoulder dislocation in six cases was the interposition of the long head of biceps (LHB in the anterior of the head that was displaced from the fracture line between the greater and lesser tuberosities. In another case, the greater and lesser tuberosities were attached to each other and were separated from the head. This fractured part was trapped. Conclusions: We suggest that performing CT scans in all cases of anterior shoulder dislocations with displaced fracture of the greater tuberosity can help surgeons to diagnose the accompanying fractures and possible complications, such as irreducibility. If the fracture line passes through the bicipital groove or in the case of a shield fracture, possible irreducibility should be borne in mind.

  4. The Western Ontario Shoulder Instability Index (WOSI): validity, reliability, and responsiveness retested with a Swedish translation

    OpenAIRE

    Salomonsson, Björn; Ahlström, Susanne; Dalén, Nils; Lillkrona, Ulf

    2009-01-01

    Background and purpose The WOSI score questionnaire is a tool designed for self-assessment of shoulder function for patients with instability problems. We made a translation into Swedish and retested the score by analyzing the psychometric properties validity, reliability, and responsiveness. Patients and methods 3 patient materials were used for the assessment: (A) a follow-up on a group of 32 patients more than 8 years after having primary posttraumatic shoulder dislocation. Evaluation of P...

  5. THE HISTORICAL REVIEW AND TRENDS IN THE DEVELOPMENT OF SURGICAL TREATMENT OF RECCURENT SHOULDER INSTABILITY

    Directory of Open Access Journals (Sweden)

    V. M. Prokhorenko

    2016-02-01

    Full Text Available An analysis of literature data was conducted to characterize the main current stage of development and formation of diagnosis and treatment of shoulder instability. The purpose of this review was to determine the main directions in the treatment of recurrent shoulder instability and problematic issues that require further scientific research. The main results of patients monitoring that were undergone different types of arthroscopic treatment were presented. The present level of diagnostics allows to accurately define the indications for surgical treatment. A method of glenoid bone defect reconstruction is presented that based on careful preoperative planning. Determination of possible risk factors and every possible pathogenesis link and individual preoperative planning are the main tasks in the prevention of the shoulder instability recurrences.

  6. MR imaging of subscapularis tendon injury in the setting of anterior shoulder dislocation

    International Nuclear Information System (INIS)

    To evaluate the degree and location patterns of subscapularis tendon injury in patients with prior anterior shoulder dislocation (ASD). Forty-five consecutive MR shoulder examinations in patients with a history of ASD and 20 consecutive MR examinations in patients without prior dislocation were reviewed. Two readers assessed for the presence and location of tendinosis and tearing in the subscapularis tendon, which was divided into three segments: superior, middle, and inferior. The readers also documented the presence of anterior labral tears, osseous Bankart defects and Hill-Sachs lesions. Fisher's exact tests were performed to analyze the different types of pathology and their locations. Subscapularis tendinosis, and partial thickness and full thickness tears were more common in patients with a history of ASD. Tendinosis was found in 60-64.4% of the dislocation patients compared with 40% of the non-dislocation group. When stratified by location, the middle and inferior thirds were the most commonly affected with statistical significance (p < 0.05) found in tearing of the inferior third. Anterior labral tears, osseous Bankart defects, and Hill-Sachs lesions were more common in the dislocation group with statistically significant associations with tendinosis in the middle and inferior thirds and tearing of the middle third (p < 0.05). Our study suggests an association between middle and inferior subscapularis tendon pathology and prior anterior shoulder dislocation. Based on our results, careful MR assessment of the subscapularis tendon by the radiologist is indicated in the setting of ASD as injury of this structure can be symptomatic and may be amenable to treatment. (orig.)

  7. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

    Directory of Open Access Journals (Sweden)

    Lützner J

    2009-01-01

    Full Text Available Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, either arthroscopically in presence of an detached, but not elongated capsulolabral complex (40 or open (159. After a median time of 31 months (12 to 67 months 174 patients were contacted and agreed to follow-up, 135 after open and 39 after arthroscopic Bankart procedure. Results Re-dislocations occurred in 8% after open and 15% after arthroscopic Bankart procedure. After open surgery 4 of the 11 re-dislocations occurred after a new adequate trauma and 1 of the 6 re-dislocations after arthroscopic surgery. Re-dislocations after arthroscopic procedure occured earlier than after open Bankart repair. An external rotation lag of 20° or more was observed more often (16% after open than after arthroscopic surgery (3%. The Rowe score demonstrated "good" or "excellent" functional results in 87% after open and in 80% patients after arthroscopic treatment. Conclusion In this retrospective investigation the open Bankart procedure demonstrated good functional results. The arthroscopic treatment without capsular shift resulted in a better range of motion, but showed a tendency towards more frequently and earlier recurrence of instability. Sensitive patient selection for arthroscopic Bankart repair is recommended especially in patients with more than five dislocations.

  8. A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, R.W.; Naeem, R.; Srinivas, K.; Shyamalan, G. [Birmingham Heartlands Hospital, Birmingham (United Kingdom)

    2015-05-01

    The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations. A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries. Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83-0.95) and 0.94 (CI 0.9-0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44-0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14-0.86). The overall positive predictive value was 0.88 (CI 0.76-0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07-0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05-0.7). Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor. (orig.)

  9. A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations

    International Nuclear Information System (INIS)

    The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations. A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries. Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83-0.95) and 0.94 (CI 0.9-0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44-0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14-0.86). The overall positive predictive value was 0.88 (CI 0.76-0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07-0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05-0.7). Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor. (orig.)

  10. The surgical treatment of the recurrent dislocation on the shoulder joint with minimum invasion anterior approach

    Directory of Open Access Journals (Sweden)

    Ninković Srđan

    2008-01-01

    Full Text Available Shoulder joint is one of the spherical joints and one of the most movable but also the most unstable joint of locomotive apparatus. The aims of this work are to review and analyze the results of medical treatment of frontal recurrent dislocations on the shoulder with open surgery technique on the Clinic for Orthopaedic Surgery and Traumatology in Novi Sad in the period from 2002 to 2005. Twenty one patients with anterior recurrent dislocations of the shoulder were operated on, 19 men and 2 women. The average age of those patients was 24.8 (15-40 year-olds. Ten patients had an injury of the left and 11 patients the injury of the right shoulder. There were eight handball players, four fighting skills players; two of them played volleyball and one was a basketball player. Six of them were not sportsmen. The preoperational and post operational mean value of the modified Rowe scale showed a statistically significant difference (P<0.001. Observing the patients after the operation in the period of 2 years, according to Neer scale, 3 patients (14.28% had great results (grade over 90, 16 patients (76.19% had a good result, (75-89, and only two patients (9.52% had results less than 75. The measuring of the volume of movements after physical treatment in 12 patients (57.14% has shown the decrease of the outside rotation. Open surgery treatment of the front unstable shoulder joint is reliable and time tested and it gives good clinical results in young sportsmen with undirected unstable, bigger number of dislocations and associated osseous defects. .

  11. Innovative use of computer-assisted tomography in the management of an irreducible anterior shoulder dislocation

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    Rajpal S Nandra

    2011-01-01

    Full Text Available Anterior dislocation of the shoulder is a common injury which is often reduced in the emergency department, without specialist orthopedic input. We report a case of an irreducible locked anterior glenohumeral dislocation with impaction of the humeral head onto the antero-inferior glenoid rim and subsequent generation of a Hill-Sachs lesion. To our knowledge, we describe the first reported case of using computer-assisted tomography to generate a sequence of movements to safely disimpact the locked dislocation without causing further iatrogenic injury or a fracture through the humeral articular surface. This novel image-assisted closed reduction technique spared the patient from the morbidity associated with performing open reduction surgery. At 6-month follow-up, the patient reported no re-dislocations, returned to work and had excellent range of motion.

  12. Modified Boytchev procedure for treatment of recurrent anterior dislocation of shoulder

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    Anant Kumar Garg

    2011-01-01

    Full Text Available Background: More than 200 different operations have been described for the treatment of recurrent anterior dislocation of shoulder. The Modified Boytchev procedure employs rerouting of the detached tip of coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis deep to subscapularis and reattaches to its anatomical location. We conducted a study on evaluation of long-term effect of modified Boytchev procedure and to compare our results with other studies published in literature. Materials and Methods: Since June 2002, modified Boytchev procedure was performed on 48 patients, who presented with recurrent anterior dislocation. 45 were men and 3 were women and were in the age group of 18-40 years (mean 27.83±4.95 years. Forty patients were affected on the dominant side and rest on the non-dominant side. The mean number of dislocations in these patients was 18.22±12.08. The mean followup period was 58.13±19.06 months (range 18-96 months. The patients were evaluated by visual analogue score, modified American Shoulder and Elbow Surgeon′s Score (ASES, and Single Assessment Numeric Evaluation (SANE score at the last followup. Results: All the patients regained almost preoperative range of forward flexion at the last followup. In the preoperative period the mean external rotation deficit at 0° and at 90° of abduction was 13.22°±5.16° and 18.06°±6.50°, respectively. At the last followup, the mean external rotation deficit at 0° and at 90° of abduction was 8.06°±2.47° and 8.95°±2.07°, respectively. This improvement in external rotation deficit was statistically significant (P<.05. Preoperative scores were compared with the most recent followup scores for all variables with use of a paired t test. All patients had significant improvement in visual analogue score, modified American Shoulder and Elbow Surgeon′s Score (ASES, and Single Assessment Numeric Evaluation (SANE score at the last followup

  13. Does surgery followed by physiotherapy improve short and long term outcome for patients with atraumatic shoulder instability compared with physiotherapy alone? - protocol for a randomized controlled clinical trial

    OpenAIRE

    Jaggi, Anju; Alexander, Susan; Herbert, Robert; Funk, Lennard; Ginn, Karen A

    2014-01-01

    Background Shoulder instability is a common problem affecting young adults. Stabilization surgery followed by physiotherapy rehabilitation has been shown to reduce the chance of further episodes of shoulder dislocation and to improve quality of life in patients who sustain a shoulder dislocation as a result of a high collision trauma, but it is unclear if surgical intervention is beneficial for patients with atraumatic shoulder instability who have structural damage at the shoulder. The aim o...

  14. Reduction of Anterior Shoulder Dislocation in Emergency Department; Is Entonox® Effective?

    Directory of Open Access Journals (Sweden)

    Babak Mahshidfar

    2011-12-01

    Full Text Available Introduction: An appropriate procedural sedation and analgesia (PSA is crucial to reduce a dislocated shoulder successfully in emergency department. This study compares sedative effect of inhalational Entonox® (En to intra-venous (IV Midazolam plus Fentanyl (F+M. Methods: 120 patients with recurrent anterior shoulder dislocation were randomly assigned into two groups. 60 patients (group F+M received 0.1 mg/kg IV Midazolam plus 3µg/kg IV Fentanyl and 60 patients (group En received Entonox® with self administration face mask on an on-demand basis. Traction/counter-traction method was used to reduce the dislocated shoulder joint in both groups. Results: 48 out of 60 (80% patients in group F+M and 6 out of 60 (10% patients in group En had successful reduction (p < 0.0001. The mean pain score reduction was 6.3 ± 1.2 for group F+M and 3 ± 0.9 for group En (p < 0.0001. There was a statistically significant difference in mean patient satisfaction (assessed with Likert score between two groups (4.45 ± 0.6 for group F+M and 2.3 ± 1 for group En; p < 0.0001. Duration of entire procedure (since the beginning of PSA up to the end of successful or unsuccessful reduction was shorter in Group F+M, but successful reductions occurred earlier in group En. No major side effect such as airway compromise, retracted respiratory depression, or circulatory failure was occurred in any group. Conclusion: Entonox® may not be an appropriate agent to help reducing a dislocated shoulder.

  15. Shoulder Magnetic Resonance Arthrography: A Prospective Randomized Study of Anterior and Posterior Ultrasonography-Guided Contrast Injections

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, M.P.; Mustonen, A.O.T. (Dept. of Radiology, Helsinki Univ. Central Hospital, Helsinki (Finland))

    2008-10-15

    Background: Magnetic resonance (MR) arthrography is an accurate imaging method for internal shoulder derangements and rotator cuff pathologies. Both anterior and posterior contrast injection techniques, under palpatory, fluoroscopic, or ultrasonographic guidance have been described in the literature. However, clinical comparisons of the injection techniques remain few. Purpose: To compare the performance of anterior and posterior ultrasonography (US)-guided arthrography injections of the shoulder regarding patient discomfort and influence on diagnostic MR reading, and to illustrate the typical artifacts resulting from contrast leakage in the respective techniques. Material and Methods: 43 MR arthrographies were prospectively randomized into anterior and posterior US-guided contrast injections and performed by two radiologists, with the study of artifacts from contrast leakage. Pain from the injections was assessed by a survey utilizing a 100-mm visual analogue scale (VAS). Results: Of the 23 anterior injections, nine caused contrast artifacts in the subscapular tendon, and in three the leakage extended further anteriorly. Of the 20 posterior injections, 12 showed injection artifacts of the rotator cuff, extending outside the cuff in seven. Two of the anterior and none of the posterior artifacts compromised diagnostic quality. In posterior injections, the leakage regularly occurred at the caudal edge of the infraspinatus muscle and was easily distinguishable from rotator cuff tears. All patients completed the pain survey. Mean VAS scores were 25.0 (median 18, SD 22) for anterior, and 25.4 (median 16, SD 25) for posterior injections. The two radiologists achieved different mean VAS scores but closely agreed as to anterior and posterior VAS scores. Conclusion: Arthrography injections were fairly simple to perform under US guidance. Patient discomfort for anterior and posterior injections was equally minor. A tailored approach utilizing anterior or posterior injections

  16. Shoulder Magnetic Resonance Arthrography: A Prospective Randomized Study of Anterior and Posterior Ultrasonography-Guided Contrast Injections

    International Nuclear Information System (INIS)

    Background: Magnetic resonance (MR) arthrography is an accurate imaging method for internal shoulder derangements and rotator cuff pathologies. Both anterior and posterior contrast injection techniques, under palpatory, fluoroscopic, or ultrasonographic guidance have been described in the literature. However, clinical comparisons of the injection techniques remain few. Purpose: To compare the performance of anterior and posterior ultrasonography (US)-guided arthrography injections of the shoulder regarding patient discomfort and influence on diagnostic MR reading, and to illustrate the typical artifacts resulting from contrast leakage in the respective techniques. Material and Methods: 43 MR arthrographies were prospectively randomized into anterior and posterior US-guided contrast injections and performed by two radiologists, with the study of artifacts from contrast leakage. Pain from the injections was assessed by a survey utilizing a 100-mm visual analogue scale (VAS). Results: Of the 23 anterior injections, nine caused contrast artifacts in the subscapular tendon, and in three the leakage extended further anteriorly. Of the 20 posterior injections, 12 showed injection artifacts of the rotator cuff, extending outside the cuff in seven. Two of the anterior and none of the posterior artifacts compromised diagnostic quality. In posterior injections, the leakage regularly occurred at the caudal edge of the infraspinatus muscle and was easily distinguishable from rotator cuff tears. All patients completed the pain survey. Mean VAS scores were 25.0 (median 18, SD 22) for anterior, and 25.4 (median 16, SD 25) for posterior injections. The two radiologists achieved different mean VAS scores but closely agreed as to anterior and posterior VAS scores. Conclusion: Arthrography injections were fairly simple to perform under US guidance. Patient discomfort for anterior and posterior injections was equally minor. A tailored approach utilizing anterior or posterior injections

  17. Resultados da cirurgia de latarjet no tratamento da instabilidade anterior traumática do ombro associada à erosão óssea da cavidade glenoidal - seguimento mínimo de um ano Results from latarjet surgery for treating traumatic anterior shoulder instability associated with bone erosion in the glenoid cavity, after minimum follow-up of one year

    OpenAIRE

    Roberto Yukio Ikemoto; Joel Murachovisky; Luis Gustavo Prata Nascimento; Rogério Serpone Bueno; Luiz Henrique Oliveira Almeida; Eric Strose; Fábio Fernando Helmer

    2011-01-01

    OBJETIVO: Avaliar o resultado da cirurgia de Latarjet para pacientes com luxação recidivante anterior do ombro com perda óssea maior que 25% da cavidade glenoidal. MÉTODO: Avaliamos 26 pacientes submetidos à cirurgia de Latarjet. O tempo médio de seguimento foi de 38 meses e a média etária, de 28 anos. Os pacientes foram avaliados quanto à amplitude de movimento e pelas escalas de Rowe e UCLA, no período pré-operatório como no período pós-operatório, radiografias do ombro para avaliar a prese...

  18. Avoiding Shoulder Injury from Resistance Training.

    Science.gov (United States)

    Durall, Chris J.; Manske, Robert C.; Davies, George J.

    2001-01-01

    Identifies shoulder exercises commonly performed in fitness centers that may contribute to or exacerbate glenohumeral joint (shoulder) injury, describing alternative exercises that may be substituted and a offering rationale for the variations. The article focuses on anterior and posterior glenohumeral instability, subacromial impingement (primary…

  19. The MR arthrographic anatomy of the biceps labral insertion and its morphological significance with labral tears in patients with shoulder instability

    Energy Technology Data Exchange (ETDEWEB)

    Jakanani, G.C., E-mail: gcjakanani@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom); Botchu, R., E-mail: drrajeshb@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom); Rennie, W.J., E-mail: winston.rennie@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom)

    2012-11-15

    Introduction: Most of the fibres of the long head of biceps tendon attach on the superior labrum just posterior to the supraglenoid tubercle. Aim: Our hypothesis was that posteriorly attached biceps tendons predispose to posterior superior labral tears and SLAP lesions. Methods and materials: A prospective analysis of all MR shoulder arthrograms for shoulder instability referred from the shoulder specialist clinics, performed during a one year period were reviewed by two independent observers who were blinded to clinical history. The biceps attachment was classified into four groups according to the method described in an earlier cadaveric study into four groups; posterior-type 1, predominantly posterior-type 2, equal contributions to both anterior and posterior labrum-type 3 and predominantly anterior labral attachment-type 4. Data was analysed using Kappa statistics and Fischer's exact test. Results: 48 patients (33 males and 15 females) were included in this study with a mean age of 32 years. Majority, 22 patients (46%) had a type 1 attachment of the biceps on the superior labrum. There was moderate intra-observer and good interobserver agreement with a Kappa of 0.58 and 0.63 respectively. There was a significant association between a type 2 attachment and posterior tears (p {<=} 0.04) and also between a type 2 attachment and SLAP tears (p {<=} 0.04). Conclusion: Our results suggest that variation in anatomy of biceps origin influences the type of labral tears that occur in patients with shoulder instability. The importance of these findings could influence selection of individuals in throwing sports like cricket and baseball.

  20. The MR arthrographic anatomy of the biceps labral insertion and its morphological significance with labral tears in patients with shoulder instability

    International Nuclear Information System (INIS)

    Introduction: Most of the fibres of the long head of biceps tendon attach on the superior labrum just posterior to the supraglenoid tubercle. Aim: Our hypothesis was that posteriorly attached biceps tendons predispose to posterior superior labral tears and SLAP lesions. Methods and materials: A prospective analysis of all MR shoulder arthrograms for shoulder instability referred from the shoulder specialist clinics, performed during a one year period were reviewed by two independent observers who were blinded to clinical history. The biceps attachment was classified into four groups according to the method described in an earlier cadaveric study into four groups; posterior-type 1, predominantly posterior-type 2, equal contributions to both anterior and posterior labrum-type 3 and predominantly anterior labral attachment-type 4. Data was analysed using Kappa statistics and Fischer's exact test. Results: 48 patients (33 males and 15 females) were included in this study with a mean age of 32 years. Majority, 22 patients (46%) had a type 1 attachment of the biceps on the superior labrum. There was moderate intra-observer and good interobserver agreement with a Kappa of 0.58 and 0.63 respectively. There was a significant association between a type 2 attachment and posterior tears (p ≤ 0.04) and also between a type 2 attachment and SLAP tears (p ≤ 0.04). Conclusion: Our results suggest that variation in anatomy of biceps origin influences the type of labral tears that occur in patients with shoulder instability. The importance of these findings could influence selection of individuals in throwing sports like cricket and baseball.

  1. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  2. The Epidemiology of Primary Anterior Shoulder Dislocations in Patients Aged 10-16 Years and Age-Stratified Risk of Recurrence

    OpenAIRE

    Leroux, Timothy; Ogilvie-Harris, Darrell; Veillette, Christian; Chahal, Jaskarndip; Dwyer, Tim; Henry, Patrick; Khoshbin, Amir; Mahomed, Nizar; Wasserstein, David

    2015-01-01

    Objectives: Most clinical studies pertaining to shoulder dislocation use age cutoffs of 16 years, and at present, only small case series of patients aged 10-16 years guide our management. Using a general population cohort aged 10 to 16 years, we sought to: 1) determine the overall and demographic-specific incidence density rate (IDR) of primary anterior shoulder dislocation requiring closed reduction (CR), and 2) determine the rate of and risk factors for repeat shoulder CR. Methods: Using ad...

  3. Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Frich, Lars Henrik; Hougaard, K.;

    1995-01-01

    The purpose of our study was to evaluate the use of static magnetic resonance imaging (MRI) as a preoperative diagnostic tool in young patients with a traumatic primary anterior shoulder dislocation. Twenty-five patients who had acute primary traumatic anterior shoulder dislocation were examined...... with MRI and arthroscopy. The patients (18 male and 7 female) were between 16 and 39 years old (mean age, 27 years). They had no previous shoulder dislocations. The dislocations were confirmed radiographically. Examination with MRI and arthroscopy was performed within 10 days after the trauma. The MRI...... joint side rotator cuff tear, 1 partial rupture of the biceps tendon, and 1 osseous Bankart lesion. Anterior capsulolabral tears and Hill-Sachs lesions appeared with a high incidence after acute anterior primary shoulder dislocation. Conventional MRI was only moderately reliable in the preoperative...

  4. Propofol Versus Midazolam for Procedural Sedation of Anterior Shoulder Dislocation in Emergency Department: A Randomized Clinical Trial

    OpenAIRE

    Hatamabadi, Hamid Reza; Arhami Dolatabadi, Ali; DERAKHSHANFAR, Hojjat; Younesian, Somaye; Ghaffari Shad, Ensieh

    2015-01-01

    Background: Anterior shoulder dislocation (ASD) is one of the most common reasons for referrals to emergency departments (ED). Usually, a combination of an intravenous narcotic and a benzodiazepine is used for procedural sedation and analgesia (PSA) in such cases. Objectives: This study compares the efficacy of two combinations to reduce ASD. Patients and Methods: The subjects in this clinical trial consisted of 48 patients with ASD who were randomly assigned to midazolam/fentanyl and propofo...

  5. Comparison of Bristow procedure and Bankart arthroscopic method as the treatment of recurrent shoulder instability

    Directory of Open Access Journals (Sweden)

    Abolghasem Zarezade

    2014-01-01

    Full Text Available Background: Anterior shoulder dislocation is the most common major joint dislocation. In patients with recurrent shoulder dislocation, surgical intervention is necessary. In this study, two methods of treatment, Bankart arthroscopic method and open Bristow procedure, were compared. Materials and Methods: This clinical trial survey had been done in the orthopedic department of Alzahra and Kashani hospitals of Isfahan during 2008-2011. Patients with recurrent anterior shoulder dislocation who were candidates for surgical treatment were randomly divided into two groups, one treated by Bankart arthroscopic technique and the other treated by Bristow method. All the patients were assessed after the surgery using the criteria of ROWE, CONSTANT, UCLA, and ASES. Data were analyzed by SPSS software. Results: Six patients (16.22% had inappropriate condition with ROWE score (score less than 75; of them, one had been treated with Bristow and five with Bankart (5.26 vs. 27.78. Nine patients (24.32% had appropriate condition, which included six from Bristow group and three treated by Bankart technique (31.58 vs. 16.67. Finally, 22 patients (59.46% showed great improvement with this score, which included 12 from Bristow and 10 from Bankart groups (63.16 vs. 55.56. According to Fisher′s exact test, there were no significant differences between the two groups (P = 0.15. Conclusion: The two mentioned techniques did not differ significantly, although some parameters such as level of performance, pain intensity, use of analgesics, and range of internal rotation showed more improvement in Bristow procedure. Therefore, if there is no contraindication for Bristow procedure, it is preferred to use this method.

  6. A biomechanical assessment of superior shoulder translation after reconstruction of anterior glenoid bone defects: The Latarjet procedure versus allograft reconstruction

    OpenAIRE

    Degen, Ryan M; Giles, Joshua W.; Harm W Boons; Litchfield, Robert B.; Johnson, James A.; Athwal, George S.

    2013-01-01

    Background : The coracoacromial ligament (CAL) is an important restraint to superior shoulder translation. The effect of CAL release on superior stability following the Latarjet is unknown; therefore, our purpose was to compare the effect of two Latarjet techniques and allograft reconstruction on superior instability. Materials and Methods : Eight cadaveric specimens were tested on a simulator. Superior translation was monitored following an axial force in various glenohumeral rotations (...

  7. Chronic instability of the anterior syndesmosis of the ankle: Biomechanical, kinematical, radiological and clinical aspects

    OpenAIRE

    Beumer, Annechien

    2007-01-01

    textabstractThis thesis is concerned with chronic anterior instability of the tibiofibular syndesmosis of the ankle. The ankle plays a fundamental role in locomotion. It consists of the talocrural and distal tibiofibular joint. The latter is a syndesmosis, a fibrous joint with ample intervening fibrous connective tissue. The syndesmosis consists of the anterior inferior tibiofibular ligament (ATiFL, also known as the anterior syndesmosis), the interosseous ligament (IL), and the posterior inf...

  8. Bristow-Latarjet Technique: Still a Very Successful Surgery for Anterior Glenohumeral Instability - A Forty Year One Clinic Experience

    Directory of Open Access Journals (Sweden)

    Vilson Ruci

    2015-05-01

    CONCLUSION: The Bristow-Latarjet procedure is a very good surgical treatment for recurrent anterior-inferior instability of the glenohumeral joint. It must not be used for multidirectional instability or psychogenic habitual dislocations.

  9. Anterior approach v. posterior approach - ultrasound-guided shoulder arthrogram injection

    OpenAIRE

    Merle Neethling-du Toit; Richard de villiers

    2008-01-01

    Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are muc...

  10. Patient Participation Approach to Reduction of Anterior Shoulder Dislocation: P-R-I-M/O-Y-E-S.

    Science.gov (United States)

    Lachance, Paul-André; Taieb-Lachance, Catherine Isabelle

    2016-07-01

    A variety of successful techniques are available for reduction of shoulder dislocation; none have been shown to be clearly superior to another. Analgesic methods vary as well from none to deep sedation-analgesia. The literature hints at the importance of optimal muscle relaxation as a factor of success. Yet, the literature describes only cursorily the means by which muscle relaxation is optimized. Patient-centered participation and relaxation methods have been used in other contexts to reduce pain, anxiety, and muscle tension. This article proposes to integrate a patient-centered participation approach to the reduction of anterior shoulder dislocation as a way to optimize muscular relaxation nonpharmacologically. It can be used in the field in combination with the practitioner's reduction technique of choice. It minimizes risks because it entails no deep pharmacological sedation. The mnemonic P-R-I-M/O-Y-E-S is used to respectively represent the four phases: Preparation, Rehearsal, Intervention, and Mobilization as well as the 4 repeated steps in each phase of the procedure: Observe, Yield control, Explain, and Support. The focus is on (1) securing optimal patient participation within a patient-centered approach and (2) achieving nonpharmacological muscular relaxation through a simple relaxation routine. More studies are needed to identify the factors that determine success and guide the practitioner's choice among available options in shoulder dislocation reductions. PMID:26584435

  11. Recurrent anterior glenohumeral instability: the quantification of glenoid bone loss using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Martins e Souza, Patricia [Fleury Medicina e Saude and Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brandao, Bruno Lobo; Motta, Geraldo; Monteiro, Martim [Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brown, Eduardo [Grupo Fleury Medicina Diagnostica, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal do Rio de Janeiro, Petropolis, RJ (Brazil)

    2014-08-15

    To investigate the accuracy of conventional magnetic resonance imaging (MRI) in determining the severity of glenoid bone loss in patients with anterior shoulder dislocation by comparing the results with arthroscopic measurements. Institutional review board approval and written consent from all patients were obtained. Thirty-six consecutive patients (29 men, seven women; mean age, 34.5 [range, 18-55] years) with recurrent anterior shoulder dislocation (≥3 dislocations; mean, 37.9; range, 3-200) and suspected glenoid bone loss underwent shoulder MRI before arthroscopy (mean interval, 28.5 [range, 9-73] days). Assessments of glenoid bone loss by MRI (using the best-fit circle area method) and arthroscopy were compared. Inter- and intrareader reproducibility of MRI-derived measurements was evaluated using arthroscopy as a comparative standard. Glenoid bone loss was evident on MRI and during arthroscopy in all patients. Inter- and intrareader correlations of MRI-derived measurements were excellent (intraclass correlation coefficient = 0.80-0.82; r = 0.81-0.86). The first and second observers' measurements showed strong (r = 0.76) and moderate (r = 0.69) interreader correlation, respectively, with arthroscopic measurements. Conventional MRI can be used to measure glenoid bone loss, particularly when employed by an experienced musculoskeletal radiologist. (orig.)

  12. Recurrent anterior glenohumeral instability: the quantification of glenoid bone loss using magnetic resonance imaging

    International Nuclear Information System (INIS)

    To investigate the accuracy of conventional magnetic resonance imaging (MRI) in determining the severity of glenoid bone loss in patients with anterior shoulder dislocation by comparing the results with arthroscopic measurements. Institutional review board approval and written consent from all patients were obtained. Thirty-six consecutive patients (29 men, seven women; mean age, 34.5 [range, 18-55] years) with recurrent anterior shoulder dislocation (≥3 dislocations; mean, 37.9; range, 3-200) and suspected glenoid bone loss underwent shoulder MRI before arthroscopy (mean interval, 28.5 [range, 9-73] days). Assessments of glenoid bone loss by MRI (using the best-fit circle area method) and arthroscopy were compared. Inter- and intrareader reproducibility of MRI-derived measurements was evaluated using arthroscopy as a comparative standard. Glenoid bone loss was evident on MRI and during arthroscopy in all patients. Inter- and intrareader correlations of MRI-derived measurements were excellent (intraclass correlation coefficient = 0.80-0.82; r = 0.81-0.86). The first and second observers' measurements showed strong (r = 0.76) and moderate (r = 0.69) interreader correlation, respectively, with arthroscopic measurements. Conventional MRI can be used to measure glenoid bone loss, particularly when employed by an experienced musculoskeletal radiologist. (orig.)

  13. Chronic instability of the anterior syndesmosis of the ankle: Biomechanical, kinematical, radiological and clinical aspects

    NARCIS (Netherlands)

    A. Beumer (Annechien)

    2007-01-01

    textabstractThis thesis is concerned with chronic anterior instability of the tibiofibular syndesmosis of the ankle. The ankle plays a fundamental role in locomotion. It consists of the talocrural and distal tibiofibular joint. The latter is a syndesmosis, a fibrous joint with ample intervening fibr

  14. Resultados do procedimento artroscópico de "remplissage" na luxação anterior recidivante do ombro Results from filling "remplissage" arthroscopic technique for recurrent anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Mauro Emilio Conforto Gracitelli

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o resultado clínico da técnica de "remplissage" associada ao reparo da lesão de Bankart (BK para o tratamento da luxação anterior recidivante do ombro. MÉTODOS: Nove pacientes (10 ombros, com seguimento médio de 13,7 meses, apresentaram luxação traumática anterior recidivante do ombro. Todos tinham lesão de BK associada à lesão de Hill e Sachs (HS, com sinal do "encaixe". O defeito das lesões de HS foi medido e apresentava em média 17,3% (7,7% a 26,7% de perda óssea em relação ao diâmetro da cabeça do úmero. Todos foram submetidos ao reparo artroscópico da lesão de BK associado ao preenchimento ("remplissage" da lesão de HS pela tenodese do infraespinal. RESULTADOS: O escore de Rowe variou de 22,5 (10 a 45 no período pré-operatório para 80,5 (5 a 100 no período pós operatório (p OBJECTIVE: To evaluate the clinical result from the filling ("remplissage" technique in association with Bankart lesion repair for treating recurrent anterior shoulder dislocation. METHODS: Nine patients (10 shoulders, with a mean follow-up of 13.7 months, presented traumatic recurrent anterior shoulder dislocation. All of them had a Bankart lesion, associated with a Hill-Sachs lesion showing the "engaging" sign. The Hill-Sachs lesion defect was measured and showed an average bone loss of 17.3% (7.7% to 26.7% in relation to the diameter of the humeral head. All the cases underwent arthroscopic repair of the Bankart lesion, together with filling of the Hill-Sachs lesion by means of tenodesis of the infraspinatus. RESULTS: The Rowe score ranged from 22.5 (10 to 45 before the operation to 80.5 (5 to 100 after the operation (p < 0.001. The UCLA score ranged from 18.0 (8 to 29 to 31.1 (21 to 31 (p < 0.001. The measurements of external and internal rotation at abduction of 90º after the operation were 63.5º (45º to 90º and 73º (50º to 92º respectively. Two patients presented recurrence (one with dislocation and the other

  15. 肩关节前脱位的诊治体会%The diagnosis and treatment of anterior shoulder dislocations

    Institute of Scientific and Technical Information of China (English)

    曹烈虎; 章浩; 张春才; 翁蔚宗; 李海航; 宋绍军; 纪方; 苏佳灿

    2014-01-01

    Objective To explore the injury assessment and the control measure for the related complication before the manual reduction of anterior shoulder dislocations.Methods General data:5 6 patients suffered anterior shoulder dislocations were retrospectively analyzed in our study.3 1 were male and 25 were female,and their ages ranged from 23 to 85 years old with the mean age of 36.5 years old.10 patients got injured at car accidents.32 injuries resulted from falling,8 of which fell from the height,and 6 were inj ured in sports.The time before going to hospital ranged from 1 5 minutes to 8 hours with a mean time of 1 .6 hours.All of the shoulder dislocations were fresh and traumatic.For the dislocation direction,31 were subcoracoid dislocations,20 were subglenoid dislocations,and 5 were subclavicle dislocations,1 5 patients were associated with fractures of greater tuberosity,1 humeral head fracture,and 3 axillary nerve inj uries,2 Iatrogenic proximal humeral fractures.Inclusion criteria:Patients had a clear history of shoulder trauma.The squared shoulder deformation was showed by physical examination,and the humeral head could be touched in the axillary,subcoracoid,or subclavicle.The shoulder dislocation was also confirmed by the radiographic diagnosis.Treatment:100 mg lidocaine was injected into the shoulder joint,and then the dislocations were reduced using the Hippocrates method after about 10 minutes when the pain was relieved.Results All the patients received closed reduction by the Hippocrates method in the emergency room.48 patients had successful reduction,8 patients failed.Of these 8 cases,closed reduction succeeded in one case with the fracture of greater tuberosity at the operation room with general anesthesia,manual reduction was done in 2 cases with brachial plexus block,and open reduction was done in one case with humeral head fracture. Conclusions A series of careful assessment should be done before gimmick reset of the anterior shoulder dislocation

  16. 关节镜下治疗创伤复发性Bankart损伤疗效分析%Clinical curative effect of the arthroscopic reconstruction for recurrent anterior dislocation of the shoulder

    Institute of Scientific and Technical Information of China (English)

    李彦林; 王国梁; 何川; 李建; 郑家礼; 陈广超; 李松; 余洋

    2014-01-01

    目的:探讨肩关节镜下Bankart损伤重建术治疗复发性肩关节前脱位的临床疗效。方法自2010年6月至2014年4月随访60例应用肩关节镜下Bankart损伤重建术治疗的复发性肩关节前脱位患者,随访10~38个月,平均26.6个月;年龄15~45岁,平均29岁。60例患者均为前方单方向性不稳定,术前平均脱位次数为6.5次(2~17次)。手术中采用缝合锚进行Bankart损伤重建术。随访时采用 ASES评分和Constant-Murley评分进行功能评估。结果60例患者手术前及终末随访时 ASES平均评分为(83.5±3.2)分与(97.1±2.1)分(t=4.79,P>0.01),肩关节平均前屈上举角度为(163.8±6.0)°与(185.4±3.9)°(t =4.87,P >0.01),外展角度为(90±1.1)°与(135.4±9.9)°(t=6.40,P>0.01),外旋角度为(57.6±4.3)°与(86.5±5.2)°(t=5.43,P >0.01);术前及终末随访时Constant-Murley平均评分为(77.6±3.5)分与(97.2±3.2)分(t=5.06,P >0.01)。终末随访时所有病例均未发生术后再脱位,术后残存恐惧试验阳性4例(6.7%)。所有患者均恢复术前工作,52例(8 6.7%)恢复到第一次脱位前的运动水平。结论肩关节镜下微创行 Bankart 损伤重建手术是治疗复发性肩关节前脱位的有效方法之一,术前病例选择、术中关节镜下操作技术及术后功能康复锻炼是手术成功的关键。%Background Recurrent dislocation of shoulder joint (or traumatic shoulder instability)initiates from the first shoulder dislocation,compromising the ligaments for stability of the shoulder.When the labrum is torn from the glenoid,the stable function of these ligaments is lost. The progression of traumatic shoulder instability and the type and degree of inj uries in glenoid labrum and surrounding ligaments are inextricably linked.Bankart injury is the most common cause of recurrent anterior shoulder dislocation,and the rehabilitation and reconstruction of stable structure in anterior shoulder is critical for the treatment of recurrent anterior

  17. Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery

    Institute of Scientific and Technical Information of China (English)

    MA Yong; AO Ying-fang; YU Jia-kuo; DAI Ling-hui; SHAO Zhen-xing

    2013-01-01

    Background Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing.This study aims to investigate the factors causing instability after primary ACL reconstruction,which may provide an essential scientific base to prevent surgical failure.Methods One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012.There were 74 men and 36 women,and the mean age at the time of revision was 27.6 years (range 16-56 years).The factors leading to instability after primary ACL reconstruction were retrospectively reviewed.Results Fifty-one knees failed because of bone tunnel malposition,with too anterior femoral tunnels (20 knees),posterior wall blowout (1 knee),vertical femoral tunnels (7 knees),too posterior tibial tunnels (12 knees),and too anterior tibial tunnels (10 knees).There was another knee performed with open surgery,where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior.Five knees were found with malposition of the fixation.One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft.Three knees met recurrent instability after postoperative infection.The other factors included traumatic (48 knees) and unidentified (12 knees).Conclusion Technical errors were the main factors leading to instability after primary ACL reconstructions,while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.

  18. Rowe and Zarins technique in the reconstruction of chronic anterior knee instability and our results

    OpenAIRE

    Kuskucu, Mesih; Kral, Ahmet; Kaplan, Haluk; Arpacioglu, Omer; Cuhadar, Kemal

    2004-01-01

    Between the years 1986-1990 in the clinic of orthopaedics and traumatology of GATA Haydarpaşa Training Hospital combined Rowe and Zarins reconstruction, semimembranosusplasty, vastusplasty, sartoriusplasty and gracilisplasty has been performed in 15 cases with chronic anterior instability. The results are evaluated according to patients history. Clinical and radiological examination and percentage to return to preinjuries level of daily and sport activities. In general estimation we ha...

  19. The posterior bone block procedure in posterior shoulder instability: a long-term follow-up study.

    Science.gov (United States)

    Meuffels, D E; Schuit, H; van Biezen, F C; Reijman, M; Verhaar, J A N

    2010-05-01

    We present the long-term outcome, at a median of 18 years (12.8 to 23.5) of open posterior bone block stabilisation for recurrent posterior instability of the shoulder in a heterogenous group of 11 patients previously reported on in 2001 at a median follow-up of six years. We found that five (45%) would not have chosen the operation again, and that four (36%) had further posterior dislocation. Clinical outcome was significantly worse after 18 years than after six years of follow-up (median Rowe score of 60 versus 90 (p = 0.027)). The median Western Ontario Shoulder Index was 60% (37% to 100%) at 18 years' follow-up, which is a moderate score. At the time of surgery four (36%) had glenohumeral radiological osteoarthritis, which was present in all after 18 years. This study showed poor long-term results of the posterior bone block procedure for posterior instability and a high rate of glenohumeral osteoarthritis although three patients with post-traumatic instability were pleased with the result of their operations. PMID:20436001

  20. MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffeler, Christoph [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kantonsspital Graubuenden, Musculoskeletal Imaging, Chur (Switzerland); Waldt, Simone; Bauer, Jan S.; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kirchhoff, Chlodwig [Technische Universitaet Muenchen, Department of Traumatology, Munich (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Munich (Germany); Schroeder, Michael [Center for Sports Orthopedics and Medicine, Orthosportiv, Munich (Germany); Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Orthopedic Sports Medicine, Munich (Germany)

    2014-06-15

    To evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images. Twenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes. The crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups. Combined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate. (orig.)

  1. Arthroscopic findings after shoulder dislocation

    OpenAIRE

    Medenica Ivica; Radunović Aleksandar; Madžarac Dragan; Zorić Miodrag; Bokonjić Dubravko; Stojković Bratislav

    2009-01-01

    Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii). Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical t...

  2. A biomechanical assessment of superior shoulder translation after reconstruction of anterior glenoid bone defects: The Latarjet procedure versus allograft reconstruction

    Directory of Open Access Journals (Sweden)

    Ryan M Degen

    2013-01-01

    Full Text Available Background : The coracoacromial ligament (CAL is an important restraint to superior shoulder translation. The effect of CAL release on superior stability following the Latarjet is unknown; therefore, our purpose was to compare the effect of two Latarjet techniques and allograft reconstruction on superior instability. Materials and Methods : Eight cadaveric specimens were tested on a simulator. Superior translation was monitored following an axial force in various glenohumeral rotations (neutral, internal, and external with and without muscle loading. Three intact CAL states were tested (intact specimen, 30% glenoid bone defect, and allograft reconstruction and two CAL deficient states (classic Latarjet (classicLAT and congruent-arc Latarjet (congruentLAT. Results : In neutral without muscle loading, a significant increase in superior translation occurred with the classicLAT as compared to 30% defect (P = 0.046 and allograft conditions (P = 0.041. With muscle loading, the classicLAT (P = 0.005, 0.002 and the congruentLAT (P = 0.018, 0.021 had significantly greater superior translation compared to intact and allograft, respectively. In internal rotation, only loaded tests produced significant results; specifically, classicLAT increased translation compared to all intact CAL states (P 0.05 and no differences (P = 1.0 were found between classicLAT and congruentLAT. Discussion: In most simulations, CAL release with the Latarjet lead to increased superior humeral translation. Conclusion: The choice of technique for glenoid bone loss reconstruction has implications on the magnitude of superior humeral translation. This previously unknown effect requires further study to determine its clinical and kinematic outcomes.

  3. Shoulder reflexes

    DEFF Research Database (Denmark)

    Diederichsen, Louise; Krogsgaard, Michael; Voigt, Michael;

    2002-01-01

    long latency (300 ms) excitatory reflex has been found when nerves in the capsule were stimulated electrically during shoulder surgery. In addition, when the anterior-inferior capsule was excited in conscious humans with modest amplitude electrical stimuli during muscle activity, a strong inhibition...... likely that the joint receptors have a more distinct role for the kinaestethic sense than muscle receptors. In cats a direct reflex from the afferents innervating the shoulder to the muscles around the shoulder has been presented. The reflex had an extremely short latency (2.7-3.1 ms). In man, a very...... was found with an average latency of 33 ms. Stimulation of the sensory nerves in the coracoacromial ligament has also been found to modify muscle activity strongly. Even though our understanding of the control of shoulder motion is incomplete, it is clear that sensory inputs can strongly modify muscle...

  4. Rugby and Shoulder Trauma: A Systematic Review.

    Science.gov (United States)

    Papalia, R; Tecame, A; Torre, G; Narbona, P; Maffulli, N; Denaro, V

    2015-01-01

    Rugby is a popular contact sport worldwide. Collisions and tackles during matches and practices often lead to traumatic injuries of the shoulder. This review reports on the epidemiology of injuries, type of lesions and treatment of shoulder injuries, risk factors, such as player position, and return to sport activities. Electronic searches through PubMed (Medline), EMBASE, and Cochrane Library retrieved studies concerning shoulder injuries in rugby players. Data regarding incidence, type and mechanisms of lesion, risk factors and return to sport were extracted and analyzed. The main reported data were incidence, mechanism of injury and type of lesion. Most of the studies report tackle as the main event responsible for shoulder trauma (between 50% and 85%), while the main lesions reported were Bankart lesions, Superior Labral tear from Anterior to Posterior (SLAP tears), anterior dislocation and rotator cuff tears. Open or arthroscopic repair improve clinical outcomes. Shoulder lesions are common injuries in rugby players. Surgical treatment seems to be effective in for rotator cuff tears and shoulder instability. More and better designed studies are needed for a higher Level of Evidence analysis of this topic. PMID:26535182

  5. Intra-articular lignocaine versus intravenous analgesia with or without sedation for manual reduction of acute anterior shoulder dislocation in adults.

    LENUS (Irish Health Repository)

    Wakai, Abel

    2012-01-31

    BACKGROUND: There is conflicting evidence regarding the use of intra-articular lignocaine injection for the closed manual reduction of acute anterior shoulder dislocations. A systematic review may help cohere the conflicting evidence. OBJECTIVES: To compare the clinical efficacy and safety of intra-articular lignocaine and intravenous analgesia (with or without sedation) for reduction of acute anterior shoulder dislocation. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 1), MEDLINE (1950 to March 2010), and EMBASE (1980 to March 2010). We searched Current Controlled Trials metaRegister of Clinical Trials (compiled by Current Science) (March 2010). We imposed no language restriction. SELECTION CRITERIA: Randomized controlled trials comparing intra-articular lignocaine (IAL) with intravenous analgesia with or without sedation (IVAS) in adults aged 18 years and over for reduction of acute anterior shoulder dislocation. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. Where possible, data were pooled and relative risks (RR) and mean differences (MD), each with 95% confidence intervals (CI), were computed using the Cochrane Review Manager statistical package (RevMan). MAIN RESULTS: Of 1041 publications obtained from the search strategy, we examined nine studies. Four studies were excluded, and five studies with 211 participants were eligible for inclusion. There was no difference in the immediate success rate of IAL when compared with IVAS in the closed manual reduction of acute anterior shoulder dislocation (RR 0.95; 95% CI 0.83 to 1.10). There were significantly fewer adverse effects associated with IAL compared with IVAS (RR 0.16; 95% CI 0.06 to 0.43). The mean time spent in the emergency department was significantly less with IAL compared with IVAS (MD 109.46 minutes; 95% CI 84.60 to 134.32). One trial reported significantly less time for

  6. Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

    Science.gov (United States)

    Ramhamadany, Eamon; Modi, Chetan S

    2016-01-01

    The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures. PMID:27335809

  7. Impingement syndrome of the shoulder

    International Nuclear Information System (INIS)

    The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.)

  8. Comparison of Shoulder Muscles Activation for Shoulder Abduction between Forward Shoulder Posture and Asymptomatic Persons

    OpenAIRE

    Yoo, Won-gyu

    2013-01-01

    [Purpose] This study investigated the differences in shoulder muscles activities during shoulder abduction between a forward shoulder posture group and asymptomatic group. [Subjects] Seven males with forward shoulder posture (FHS) and seven asymptomatic males were recruited. [Methods] We measured the upper and middle trapezius (UT and MT), serratus anterior (SA), and clavicle portion of the pectoralis major (cPM) in the right side during shoulder abduction. [Results] The activities of the UT ...

  9. Assessment of rotatory instability after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft

    International Nuclear Information System (INIS)

    Anatomically oriented anterior cruciate ligament (ACL) reconstruction has been advocated recently, but its effect on rotatory instability remains to be cleared objectively. The purpose of this study was to quantitatively evaluate rotatory instability in ACL reconstructed knees with a bone-patellar tendon-bone (BTB) graft using an open MRI system. Eighteen subjects underwent arthroscopic ACL reconstruction with a BTB graft. The tibial tunnel was placed in the center of the ACL footprint. The femoral tunnel was drilled transtibially at the 10:00 to 10:30-o'clock position for the right knees. Subjects were examined using a Slocum anterolateral rotatory instability test in open MRI. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Anterior knee stability was evaluated using the KT-2000 arthrometer. The clinical knee function was assessed with the Lysholm and Tegner scoring scales before and after the surgery. Side-to-side differences of anterolateral tibial translation was 0.1 mm. Side-to-side difference on KT-2000 arthrometer measurement was 1.8 mm. The Lysholm score improved to 96 and the latest Tegner score reached substantially the preinjury level. ACL reconstruction with a BTB graft was successful in restoring rotatory stability as well as anterior stability and knee function. (author)

  10. 肩关节镜治疗复发性肩关节前脱位%Arthroscopic treatment of recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    马佳; 崔国庆; 王健全; 肖健; 敖英芳; 于长隆

    2008-01-01

    目的 对关节镜治疗复发性肩关节前脱位的疗效进行评价.方法 2001年1月至2006年3月关节镜治疗复发性肩关节前脱位患者52例,其中44例获得随访,随访时间12~54个月,平均26个月.对获得随访的44例患者的临床资料进行回顾性研究.采用美国加州洛杉矶大学肩关节评分系统(UCLA)、肩关节简明测试(SST)、Dawson评分对术后效果进行评价.采用Dawson评分对患者年龄、是否存在松弛、术前脱位频率、复位情况和病程长短等因素对术后疗效的影响进行评价.结果 获得随访的44位患者的脱位复发率为4.5%.术后UCLA、SST、Dawson评分与术前比较差异具有统计学意义,肩关节镜治疗术后优良率在91%以上.患者年龄、病程长短、术前脱位频率、是否伴有关节松弛、复位方法对治疗效果无明显影响.结论 关节镜治疗复发性肩关节前脱位手术效果较好,术后肩关节功能改善明显.%Objective To investigate the effect of the arthroscopic procedure on the patients with recurrent anterior shoulder dislocation. Methods From January 2001 to March 2006, 52 patients with recurrent anterior shoulder dislocation were treated by arthroscopy. Among them 44 patients were followed up for 12 to 54 months(on average of 26 months). The data of the 44 patients was reviewed. Three evaluation systems,University of California at Los Angeles Shoulder Scores(UCLA),Simple Shoulder Test(SST) and Dawson,were used. The study evaluated the effect based on the Dawson system by the factors as:age,course of the disease, frequency of dislocation and relocation methods and the range of shoulder movement.Results The ratio of recurrent dislocation after operation was 4.5%. Assessing through 3 evaluation systems,UCLA,SST and Dawson,results were similar:the follow-up evaluation were extraordinarily different from preoperative assessment,and the rating of good or excellent at the time of the final follow-up reached 91

  11. Management of In-Season Concurrent Rotator Cuff Tear With Shoulder Instability in Professional Contact Football Athletes; Respect the Career Goals!

    Science.gov (United States)

    Mueller, Maike; Hoy, Gregory; Branson, Ruben

    2016-01-01

    Introduction Professional sports injuries are usually all dealt with at one single operation to return the player to the sport after appropriate rehabilitation. We questioned the assumption that rotator cuff tears must be repaired concurrently with instability syndromes, and aimed to allow a professional rugby league player to achieve career goals by NOT correcting all pathology at one surgery. Case Presentation A professional rugby league player presented with acute shoulder instability on a setting of a chronic full thickness rotator cuff tear. We performed an “in season” arthroscopic stabilization on an elite rugby league player, leaving a previously diagnosed large full thickness rotator cuff tear untreated. This allowed aggressive rehabilitation and return to contact competition at 12 weeks post-surgery. The player achieved a long held career goal of winning a premiership ring before undertaking rotator cuff repair at the end of the season. Latest follow up at seven years (still at elite level) demonstrated an asymptomatic shoulder. Conclusions The assumption that all pathology found at surgical exploration requires correction to play at elite level is not universally correct. We postulate that whilst rotator cuff deficiency has severe long-term sequelae, it is shoulder instability alone that prevents high level contact sports participation. Career goal management is an important part of managing elite level athletes. We have demonstrated that by careful management of the specific pathology preventing participation can allow elite athletes to achieve career goals without compromising long-term health.

  12. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... learned that this anterior soft tissue repair is critical for the stability of the implant. And certainly, ... learn about shoulder replacement. You can do a skills course at the learning center that the academy ...

  13. Restoration of Anterior-Posterior Rotator Cuff Force Balance Improves Shoulder Function in a Rat Model of Chronic Massive Tears

    OpenAIRE

    Hsu, Jason E.; Reuther, Katherine E.; Sarver, Joseph J.; Lee, Chang Soo; Thomas, Stephen J.; Glaser, David L.; Soslowsky, Louis J.

    2011-01-01

    The rotator cuff musculature imparts dynamic stability to the glenohumeral joint. In particular, the balance between the subscapularis anteriorly and the infraspinatus posteriorly, often referred to as the rotator cuff “force couple,” is critical for concavity compression and concentric rotation of the humeral head. Restoration of this anterior-posterior force balance after chronic, massive rotator cuff tears may allow for deltoid compensation, but no in vivo studies have quantitatively demon...

  14. MR ARTHOGRAPHY OF THE GLENOHUMERAL JOINT : ITS ROLE IN THE EVALUATION OF SHOULDER INSTABILITY AND PERSISTENT PAIN

    Directory of Open Access Journals (Sweden)

    Thukral

    2015-05-01

    Full Text Available BACKGROUND : The purpose of the study was to evaluate the role of MR arthrography in identification and characterization of normal variants , rotator cuff tears and tears of labro - ligamentous complex of the glenohumeral joint and compare it with conventional MRI . AIMS AND OBJECTIVES : Identification , signal characterization and grading of rotator cuff tears and to detect , localize and characterize tears of the labroligamentous complex and to differentiate them from the normal variants . METHODS : Thirty three patients in the age group of 18 - 60 years with history of shoulder instability or persistent pain due to previous injury were prospectively evaluated with conventional MRI fol lowed by MR arthrography . Patients with active joint infection , contrast allergy and joint effusion were excluded from the study . Conventional MRI and MR arthrographic findings were recorded separately and then compared . RESULTS : Statistically significant difference was found between conventional MRI and MR arthrography in the identification and characterization of labro - ligamentous tears while no statistical difference was found between the two in detection of rotator cuff tears . High incidence of co - occur rence was found between hill - sachs defect and bankart lesions/variants . CONCLUSIONS : MR arthrography is superior to conventional MRI for the delineation of intra - articular structures of the glenohumeral joint and in the detection and characterization of labral tears . Since rotator cuff tears are commoner in older age group in comparison to labral tears which are commoner in patients aged less than 40 years , MR arthrography is the imaging modality of choice in younger age group , irrespective of the clinica l indication .

  15. Arthroscopic treatment of the athletic recurrent shoulder anterior dislocations%运动员复发性肩关节前脱位的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    马佳; 崔国庆; 王健全; 肖健; 闫辉; 杨渝平; 刘玉雷; 敖英芳; 于长隆

    2009-01-01

    目的 评价关节镜下肩关节前向稳定手术对运动员复发性肩关节前脱位的治疗效果.方法 2001年1月至2006年12月,应用关节镜下肩关节前向稳定手术治疗运动员复发性肩关节前脱位29例,男15例,女14例;年龄15~35岁,平均(20.7±1.4)岁.手术均采用关节镜下盂唇缝合固定术(带线锚钉技术),必要时辅以关节囊折叠缝合术、旋转间隙闭合术或热皱缩术.以脱位复发率、肩关节活动度、恢复运动水平级别及UCLA、Dawson、SST评分系统对术后疗效进行评价.结果 全部病例随访17~66个月,平均30.2个月.4例(13.8%)失败,其中3例(10.3%)脱位复发,1例发生半脱位.24例(82.8%)基本恢复到伤前运动水平(恢复≥90%).UCLA、Dawson及SST评分与术前比较差异均有统计学意义.优良率82.8%~89.7%.术后患侧前屈、0°外展位及90°外展位外旋活动度较术前增加,与健侧差值的差异均有统计学意义.结论 运动员复发性肩关节前脱佗的关节镜下肩关节前向稳定手术的治疗效果良好,术后肩关节功能评分及关节活动度有明显改善,脱位复发率及运动水平的恢复程度与大多数文献报道的切开手术效果相近.%Objective To assess the results of arthroscopic anterior shoulder stabilization of athletes with recurrent anterior shoulder dislocations. Methods From Jan. 2001 to Dec. 2006, 29 athletes (15 males and 14 females) suffered recurrent anterior shoulder dislocations underwent arthroscopic anterior shoulder stabilizations. The age of the patients at the time of surgery was from 15 to 35 years (average, 20.7±1.4 years). The surgical procedure was performed in a consistent manner:, arthroscopic suture anchor repair of the displaced labrum, rotator interval closure supplemented with thermal treatment of the capsule when indicat-ed. The clinical results, including the postoperative recurrence rate, range of motion, and the levels of post-operative recovered to

  16. One stage anterior-posterior approach for traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    WANG Chang-sheng; LIU Mou-jun; LIN Jian-hua; XU Wei-hong; LUO Hong-bin

    2011-01-01

    Objectives: To explore the clinical features of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI), and to analyze the feasibility, indication and therapeutic effects of anterior-posterior approach in such cases.Methods: From March 2004 to September 2009, 16cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixation and bone graft fusion were conducted to manage traumatic atlantoaxial instability. As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied.Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All patients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA) scores ranged from 10to 16 one year postoperatively, 13.95±2.06 on average (improvement rate= 70.10% ). X-rays, spiral CT and MRI confirmed normal cervical alignments, complete decompression and fine implants' position. There was no breakage or loosening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed.Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal

  17. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

    Science.gov (United States)

    Godinho, Glaydson Gomes; Freitas, José Márcio Alves; de Oliveira França, Flávio; Santos, Flávio Márcio Lago; de Simoni, Leandro Furtado; Godinho, Pedro Couto

    2016-01-01

    Objective To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. Methods Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A) or greater than or equal to 3.0 cm (group B). All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles) score and strength measurements. Results The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743). Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416). Conclusion The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation. PMID:27069884

  18. Shoulder replacement - discharge

    Science.gov (United States)

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; ...

  19. Shoulder arthroscopy

    Science.gov (United States)

    ... cuff repair Shoulder CT scan Shoulder MRI scan Shoulder pain Patient Instructions Rotator cuff exercises Rotator cuff - self-care Shoulder surgery - discharge Surgical wound care - open Using your ...

  20. One stage anterior-posterior approach for traumatic at- lantoaxial instability combined with subaxial cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    WANG Chang-sheng

    2011-06-01

    Full Text Available 【Abstract】 Objectives: To explore the clinical fea- tures of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI, and to analyze the feasibility, indication and therapeutic effects of ante- rior-posterior approach in such cases. Methods: From March 2004 to September 2009, 16 cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixa- tion and bone graft fusion were conducted to manage trau- matic atlantoaxial instability . As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied. Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All pa- tients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA scores ranged from 10 to 16 one year postoperatively, 13.95±2.06 on average (improvement rate=70.10%. X-rays, spiral CT and MRI con- firmed normal cervical alignments, complete decompression and fine implants’ position. There was no breakage or loos- ening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed. Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immedi- ately restore the normal alignments and stability of the cer- vical spine and effectively

  1. Common Shoulder Injuries in American Football Athletes.

    Science.gov (United States)

    Gibbs, Daniel B; Lynch, T Sean; Nuber, Erika D; Nuber, Gordon W

    2015-01-01

    American football is a collision sport played by athletes at high speeds. Despite the padding and conditioning in these athletes, the shoulder is a vulnerable joint, and injuries to the shoulder girdle are common at all levels of competitive football. Some of the most common injuries in these athletes include anterior and posterior glenohumeral instability, acromioclavicular pathology (including separation, osteolysis, and osteoarthritis), rotator cuff pathology (including contusions, partial thickness, and full thickness tears), and pectoralis major and minor tears. In this article, we will review the epidemiology and clinical and radiographic workup of these injuries. We also will evaluate the effectiveness of surgical and nonsurgical management specifically related to high school, collegiate, and professional football athletes. PMID:26359844

  2. Analysis of hand foot pedal method in the treatment of 56 cases anterior shoulder dislocation%56例手牵足蹬法治疗肩关节前脱位的临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    陈玉保

    2015-01-01

    Objective:To analyze the clinical effect of hand foot pedal method in the treatment of anterior dislocation of the shoulder. Methods:Retrospective analysis of the hand and foot pedal method treatment of 56 cases of patients with anterior dislocation of shoulder joint.Results:56 cases were all successful reduction, good treatment effect.Conclusion:The hand and foot pedal method should be ef-fective for the treatment of anterior dislocation of shoulder joint , and fewer complications.%目的:分析手牵足蹬法治疗肩关节前脱位的临床效果。方法:回顾性分析我院采用手牵足蹬法治疗的56例肩关节前脱位患者。结果:56例全部复位成功,治疗效果良好。结论:手牵足蹬法是治疗肩关节前脱位的有效方法,且并发症少。

  3. Open MR imaging of the unstable shoulder in the apprehension test position: description and evaluation of an alternative MR examination position

    International Nuclear Information System (INIS)

    The aim of this study was to describe and evaluate an alternative MR assessment procedure for analysis of unstable shoulders. Twelve patients with unilateral recurrent anterior shoulder dislocation had both shoulders examined. Magnetic resonance imaging was performed with an open-MR system in the apprehension position with the shoulder in 90 of abduction and maximum tolerable external rotation. Contrast enhancement was achieved with intravenous gadolinium. Correlations were made to the findings at operation. In 10 of 12 unstable shoulders the inferior glenohumeral ligament labral complex (IGHLLC) was detached from the glenoid as seen on MR and later verified during surgery. In one shoulder MR was unable to show a capsulolabral detachment that was verified at surgery, whereas in one shoulder both MR and surgical assessment revealed no soft tissue detachment (accuracy 92 %). A Hill-Sachs lesion was visualized and verified in all unstable shoulders, whereas the stable controls revealed normal IGHLLC and no Hill-Sachs lesion. Open-MRI evaluation of the shoulder in the apprehension test position may become a useful tool for the evaluation of anterior shoulder instability. (orig.)

  4. Risk Factors for Recurrent Shoulder Dislocation Arthroscopically Managed with Absorbable Knotless Anchors

    Directory of Open Access Journals (Sweden)

    Raffaele Russo

    2014-01-01

    Full Text Available Purpose. To evaluate the clinical outcome and risk factors for recurrent dislocation after arthroscopic stabilization with absorbable knotless anchor. Methods. We treated 197 patients affected by anterior shoulder instability, either traumatic or atraumatic with the same arthroscopic suture technique. We recorded age at surgery and number and type of dislocations (traumatic/atraumatic. Of the 197 patients, 127 (65.4% were examined with a mean follow-up of 5.6 years (range: 25–108 months. Eighty-one shoulders were evaluated with the Rowe score and 48 with the Simple Shoulder Test (SST. Results. The mean Rowe score was 90.8, while the mean SST score was 10.9. Recurrence occurred in 10 cases (7.7% but only in 4 cases was atraumatic, which reduces the real recurrence rate to 3.1%. Patients with recurrence were significantly younger at surgery than patients who did not relapse (P=0.040. Moreover, neither the number (P=0.798 nor the type of shoulder instability (P=0.751, or the amount of glenoid bone loss (P=0.184 significantly affected the probability of recurrence. Conclusions. In a patient population with involuntary monodirectional anterior shoulder instability, use of absorbable knotless anchor was reliable and resulted in a good outcome. In this series the statistical significant risk factors for recurrent dislocation were age of patient.

  5. 关节镜下盂唇修补与关节囊复合部分肩胛下肌紧缩修复复发性肩关节前脱位%Arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    徐斌; 涂俊

    2015-01-01

    BACKGROUND:Arthroscopic glenoid labrum repair is the main therapy for recurrent anterior shoulder dislocation, which cannot meet the demands of shoulder stability. How to strengthen the anterior shoulder stability is an issue that is always explored and pursued. OBJECTIVE:To explore the effectiveness of arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation. METHODS:Seventy patients admitted for recurrent anterior shoulder dislocation at the Department of Orthopedics, First Affiliated Hospital of Anhui Medical University in China from October 2010 to August 2013 were enroled, who received the arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture. Patients undergoing post-operative systematical rehabilitation were folowed up for Constant-Murley Score and the ROWE Score for Instability, and shoulder stability and motor functions were evaluated in patients. RESULTS AND CONCLUSION: The 70 patients were folowed-up for 11-46 months. Complications only appeared in one patient with acute pulmonary edema and five patients with elbow or forearm skin blisters, but al were cured by treatment. Anterior shoulder dislocation disappeared postoperatively in al patients. Sixty-five patients almost recovered in the range of motion of the shoulder, who were satisfied with normal life and work activity. Al the patients returned to work. At the last folow-up, the Constant-Murley score was improved from 71.2±5.3 to 94.3±4.9, and the ROWE score was increased from 32.1±4.2 to 95.1±4.7, both of which were better than before (P < 0.05). This study demonstrated arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture is better for recurrent anterior shoulder dislocation, which is conductive to shoulder stability and motor function recovery.%背景:复发性肩关节前脱位的修复目前以关节镜下盂唇修补为主,

  6. Latarjet 手术治疗癫痫患者复发性肩关节前脱位伴重度骨缺损的短期疗效分析%Curative effect analysis on Latarjet procedure in treatment of epileptic patients of recurrent anterior dislocation of shoulder with severe osseous deficiency with 3-5 years follow-up

    Institute of Scientific and Technical Information of China (English)

    杨国勇; 向明; 陈杭; 胡晓川; 唐浩琛

    2014-01-01

    after surgery,there was no evidence of fixation failure or graft resorption in the shoulders.No one underwent revision surgery.Overall,most of the patients had satisfactory pain relief and daily living activities postoperatively at the time of the latest follow-up.Conclusions The anterior dislocation of the shoulder in the epileptic patients is really uncommon.The treatment of the secondary recurrent anterior dislocations of the shoulder associated with severe osseous deficiency is quite difficult,due to the unacceptably high rate of re-dislocation after the open or arthroscopic reconstruction surgery of the Bankart lesion.Our study assessed the effects of Latarjet procedure on the radiological and clinical results in seven cases with severe glenoid osseous deficiency accompanied with epileptic seizure disorders and recurrent anterior dislocation of shoulder.The results suggested that when treating patients with an epileptic seizure disorder and recurrent anterior glenohumeral instability,effective control of the epileptic seizures is one of the most important methods to reduce the incidence of post-operative recurrent dislocation,because a compliant patient was very important for a successful clinical outcome.The Latarjet procedure can provide a satisfied reconstruction of shoulder stability,but the possibility of re-dislocation and osteoarthritis should be also noticed.We recommend a high index of suspicion when treating patients with a seizure disorder who have anterior shoulder instability,and we recommend making a preoperative CT scan,if there is a strong likelihood that a coracoid transfer will be used at surgery.This enables the diagnosis of a coracoid fracture nonunion to be made prior to surgery and helps to determine whether there is sufficient bone to allow a Latarjet procedure to be performed.However,it needs further investment to choose an appropriate surgery procedure for the untreated epileptic patients.

  7. Shoulder proprioception in baseball pitchers.

    Science.gov (United States)

    Safran, M R; Borsa, P A; Lephart, S M; Fu, F H; Warner, J J

    2001-01-01

    We examined proprioceptive differences between the dominant and nondominant shoulders of 21 collegiate baseball pitchers without a history of shoulder instability or surgery. A proprioceptive testing device was used to measure kinesthesia and joint position sense. Joint position sense was significantly (P =.05) more accurate in the nondominant shoulder than in the dominant shoulder when starting at 75% of maximal external rotation and moving into internal rotation. There were no significant differences for proprioception in the other measured positions or with kinesthesia testing. Six pitchers with recent shoulder pain had a significant (P =.04) kinesthetic deficit in the symptomatic dominant shoulder compared with the asymptomatic shoulder, as measured in neutral rotation moving into internal rotation. The net effect of training, exercise-induced laxity, and increased external rotation in baseball pitchers does not affect proprioception, although shoulder pain, possibly due to rotator cuff inflammation or tendinitis, is associated with reduced kinesthetic sensation. PMID:11641701

  8. Frozen shoulder

    Science.gov (United States)

    ... a frozen shoulder are: Decreased motion of the shoulder Pain Stiffness Frozen shoulder without any known cause starts ... If you have shoulder pain and stiffness and think you have a frozen shoulder, contact your health care provider for referral and treatment.

  9. 肩关节前脱位坐位复位法及其解剖学基础%Anterior Dislocation of Shoulder Joint Seat reset Method and Its Anatomical Basis

    Institute of Scientific and Technical Information of China (English)

    韩七十三

    2015-01-01

    Objective To study and analysis the anterior dislocation of shoulder joint seat reset method and anatomical basis. Methods According to the clinical work, 27 cases of patients with symptoms of shoulder joint dislocation were under the treatment through seat reset technology by orthopaedic surgeons. Results Through the treatment of shoulder joint dislocation by seat reset method, 25 cases succeeded and 2 cases after two reset successful, this method was effective. Conclusion Shoulder joint relevant anatomy knowledge and master reset technology, was great helpful to improve treatment and anterior dislocation of shoulder joint, seat reset method was worth promoting.%目的:研究分析肩关节前脱位坐位复位法与解剖学基础。方法针对临床工作中的27例具有肩关节脱位症状的患者,骨科医生通过坐位复位技术对其进行治疗。结果通过对肩关节脱位的患者进行坐位复位法治疗,25例一次性就复位成功,另外2例经过两次复位成功,此方法效果显著。结论了解肩关节相关解剖学知识与掌握复位技术,对治疗和改善肩关节前脱位有很大帮助,坐位复位法值得推广。

  10. Reducing Shoulder by Vertical Traction: A One-Man Method for Shoulder Reduction

    OpenAIRE

    Hayat Ahmad Khan; Younis Kamal; Mohammad Ashraf Khan; Munir Farooq; Naseemul Gani; Nazia Hassan; Adil Bashir Shah; Mohammad Shahid Bhat

    2016-01-01

    Fifty percent of joint dislocations reported to the emergency department are of shoulder joint. Various techniques are used to reduce the shoulder and Spaso technique is the least known to the orthopaedic residents which is a simple one-man vertical traction method of shoulder reduction. We evaluated the effectiveness of vertical traction method for anterior shoulder dislocation by orthopaedic residents. Sixty consecutive patients of anterior glenohumeral dislocation attending the emergency d...

  11. Proximal humerus derotational osteotomy for internal rotation instability after locked posterior shoulder dislocation: early experience in four patients

    OpenAIRE

    Ziran, Bruce; Nourbakhsh, Ali

    2015-01-01

    Background We performed a retrospective and descriptive study to determine the feasibility of proximal humerus derotational osteotomy in younger patients with significant humeral head depression, who may not be good candidates for shoulder arthroplasty. Methods Rotational osteotomy was done on four patients with a mean age of 40 for locked posterior dislocation associated with a reverse Hill-Sachs lesion from 2000–2011. The average age was 40 +/− 11 years old and the average follow up was 22 ...

  12. MRI of the shoulder

    International Nuclear Information System (INIS)

    Magnetic resonance imaging has become available at a time in which shoulder pathology is more frequently seen. It is a noninvasive procedure that does not use ionizing radiation. It provides detailed visualization of soft-tissue structures that is not possible with other imaging modalities. Though not as widely available as conventional radiographs or computed tomography scanning, the number of MRI units worldwide is increasing steadily. The main features of the present book are as follows: The physical basis of Magnetic Resonance Imaging (MRI), normal shoulder anatomy and MRI, diagnosis of shoulder disorders, MRI of patients with shoulder pain or instability, case studies as well as treatment of shoulder disorders. (orig./MG) With 145 figs

  13. Shoulder arthroscopy

    Science.gov (United States)

    ... repair; SLAP lesion; Acromioplasty; Bankart repair; Bankart lesion; Shoulder repair; Shoulder surgery; Rotator cuff repair ... their tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm ...

  14. Shoulder pain

    Science.gov (United States)

    Pain - shoulder ... The shoulder is the most movable joint in the human body. A group of 4 muscles and their tendons, called the rotator cuff, give the shoulder its wide range of motion. Swelling, damage, or ...

  15. Painful/unstable shoulder

    International Nuclear Information System (INIS)

    This paper reports on the diagnostic performance of CT-arthrography of the painful/unstable shoulder that was evaluated in more than 300 patients. We have encountered a great variety of painful shoulder pathology, including impingement syndrome, cuff tear arthropathy, lesions of the long head of the biceps tendon, calcifying tendinitis, adhesive capsulitis, dead arm syndrome, and degenerative joint disease. Lesions related to instability include cases of capsular avulsions, disruption of the glenohumeral ligaments, labral pathology, glenoid fractures, Hill-Sachs lesions, and changes in glenoid angulation. CT-arthrography is an accurate exploration for both unstable and painful shoulders

  16. Midterm results after operatively stabilised shoulder dislocations in elderly patients

    OpenAIRE

    Maier, Marcus; Geiger, Emanuel V.; Ilius, Christine; FRANK, JOHANNES; Marzi, Ingo

    2008-01-01

    Anterior shoulder dislocation is frequently seen in young patients. The therapeutic regime in elderly patients after shoulder dislocation is less clearly defined. The aim of this study was to compare the clinical benefit of operative stabilisation following anterior shoulder dislocation in young versus elderly patients. Seventy-two patients with anterior shoulder dislocations were allocated into two groups. Group 1 (> 40 years of age) consisted of 23 patients, and group 2 (

  17. 外旋牵引指推法治疗老年人肩关节前脱位%Extorsion traction and pushing manipulation with fingers for the treatment of anterior shoulder dislocation in elder-ly

    Institute of Scientific and Technical Information of China (English)

    郗海涛; 黄海晶; 辛景义

    2014-01-01

    Objective:To investigate a manipulating therapy for treatment of anterior shoulder dislocation in elderly. Methods:From October 2011 to June 2012,27 elderly patients with anterior shoulder dislocation were treated by extorsion traction and pushing manipulation with fingers ,including 7 males and 20 females aged from 65 to 86 years old with an average of 77. The course of disease ranged from 1 h to 1 d. The shoulder manifested square deformity ,Dugus signs showed positive, and X ray displayed anterior shoulder dislocation. Dugus fixation was applied for and removed external fixation at 3 weeks after operation and carried out shoulder functional exercise. Functional evaluation standard on shoulder joint injuries was used for e-valuate clinical outcomes. Results:All patients were gained reduction for the first time ,and followed up at 3 months after oper-ation,no dislocation occurred. According to functional evaluation standard on shoulder joint injuries ,22 cases got an excellent result,2 cases good,and 1 case moderate. Conclusion:Extorsion traction and pushing manipulating therapy for treatment of anterior shoulder dislocation in elderly,which has advantages of simple,convenient,less painful,and can avoid iatrogenic in-jury,is feasible to widespread.%目的:探讨一种治疗老年人肩关节前脱位的复位方法。方法:自2011年10月至2012年6月,采用外旋牵引指推法治疗老年人肩关节前脱位27例,男7例,女20例;年龄65~86岁,平均77岁;病程1 h~1 d。患者呈方肩畸形,Dugus征阳性,X线片示肩关节前脱位。术后采用Dugus位固定,3周后去除外固定行患肩功能锻炼。按肩关节损伤的功能评定标准进行疗效评定。结果:患者均1次复位成功,25例获随访,时间为术后3个月,术后未出现再次脱位。按肩关节损伤的功能评定标准进行评定,优22例,良2例,中1例。结论:外旋牵引指推法治疗老年人肩关节前脱位具有简

  18. Resultado funcional do tratamento artroscópico da instabilidade do ombro sem a lesão do lábio da glenóide Functional results of arthroscopic treatment of shoulder instability without glenoid labral lesion

    Directory of Open Access Journals (Sweden)

    Waldo Lino Júnior

    2007-07-01

    Full Text Available OBJETIVO: Tratar a instabilidade anterior e ântero-inferior do ombro sem lesão do lábio da glenóide por via artroscópica por meio de capsulorrafia térmica e fechamento do espaço rotador e avaliar os resultados quanto à estabilidade e à melhora funcional. MÉTODOS: Entre janeiro de 1998 e junho de 2002, 11 pacientes foram submetidos a esse procedimento, imobilizados por cinco semanas e após tratados por fisioterapia. Todos os pacientes foram avaliados no pré e pós-operatório pelas escalas de Neer, Rower e UCLA e, no pós-operatório, pela escala de ASES. RESULTADOS: Durante o período de seguimento entre 46 e 97 meses média de 75,54 meses todos os ombros permaneceram estáveis. Comparando-se a evolução do pré ao pós-operatório, houve melhora de acordo com a escala de Neer, na qual nenhum paciente apresentou resultado satisfatório no pré-operatório e oito tiveram resultado satisfatório no pós-operatório. Segundo a escala de Rowe, a média pré-operatória foi de 36,8 e, no pós-operatório, de 81,6 pontos. Conforme a escala da UCLA, a média no pré-operatório foi de 23,45 e, no pós-operatório, de 31,18 pontos. De acordo com todas essas escalas houve melhora estatisticamente significativa (p = 0,05. A escala da ASES mostrou média pós-operatória de 77,2 pontos. CONCLUSÃO: O procedimento artroscópico analisado confere estabilidade e melhora funcional.OBJECTIVE: Anterior and anterior-lower instability of the shoulder without a glenoid labral lesion was arthroscopically treated by thermal capsulorrhaphy and closing of the rotator space, and results were evaluated for stability and functional improvement. METHODS: From January 1998 to June 2002, 11 patients were submitted to this procedure, immobilized for five weeks, and then treated by physiotherapy. All patients were evaluated pre- and post-operatively by the Neer, Rower, and UCLA scale, and in the post-operative period, by the ASES scale. RESULTS: During the follow

  19. Application of MSCT and MRI in diagnosing Bankart injury of recurrent anterior dislocation of shoulder joint%MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值

    Institute of Scientific and Technical Information of China (English)

    易雪冰; 张德洲; 钟鉴

    2011-01-01

    目的:探讨MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值.方法:回顾性分析经临床、影像证实的复发性肩关节前脱位Bankart病损10例患者的MSCT、MRI表现,主要观察肩关节盂唇前方的CT、MRI改变.结果:10例中,CT发现肩关节盂前下份撕脱性骨折4例,MRI发现肩关节前下盂唇撕脱性骨折1例;MRI发现肩关节盂唇损伤10例,CT不能显示;CT发现合并Hill-Sachs损伤6例,MRI发现Hill-Sachs损伤8例;CT未能发现肱骨头骨挫伤3例;MRI发现肩袖损伤6例,Slap损伤1例.结论:MSCT、MRI能够相互补充,清晰显示Bankart病损及其他合并病变,为临床诊断及治疗提供更加充分的资料.%Objective : To investlgate the application of MSCT and MRI in B ankart injury of recurrent anterior dislocation of shoulder joint Methods :Retrospectively analyse 10 cases Bankart injury of recurrent anterior dislocatlon of shoulder joint by clinic and radiology.Analysed the manifestations of shoulder joint an terior labrum articularis of spiralCT and MRI.Results : In 10 cases of Bankart injury of recurrent an terior dislocation of shoulder pint , there were 4 cases of avulsion fiacture of shoulder pint anterior labrum examined by CT , 1 case by MRI; 6 cases of Hill-Sachs injury were found examined by CT , 8 cases of Hill-Sachs injury and 3 cases of bone contusion of hum eralhead were found by MRI; 6 cases of rotator cuff injury and 1 case of slap injury were found exam ined by MRI.Conclusion :Spial CT and MRI can display Bankart injury and other coexisting lesion , which provide sufficient data for the clinic.

  20. [Stability versus mobility of the shoulder. Biomechanical aspects in athletes].

    Science.gov (United States)

    Pastor, M F; Smith, T; Struck, M; Wellmann, M

    2014-03-01

    The demand profile of athletes shoulders is high. On the one hand the shoulder has to provide a maximum active range of motion that allows rapid movements of the arm and on the other hand it has to be sufficiently stabilized to decelerate rapid movements and to neutralize the resulting translational forces. Two general types of instability can be differentiated in athletes shoulders: the macroinstability typically occurring in athletes involved in contact sports and the microinstability occurring in athletes involved in overhead sports.Repetitive abduction and external rotation movements of athletes involved in overhead sports lead to adaptation of the glenohumeral joint capsule and ligaments. The anterior capsule becomes stretched while the posterior capsule develops tightness. These adaptations can result in an anterior microinstability as well as posterosuperior impingement (PSI) which implicates a pathological contact of the posterosuperior rotator cuff with the posterior glenoid and which is also associated with SLAP lesions. In contrast the shoulders of swimmers are prone to anterosuperior impingement because the arm stroke involves a forceful combined anteflexion, adduction and internal rotation of the arm.The macroinstability of contact athletes is caused by sufficient trauma and characterized by a structural lesion of capsulolabral or bony lesion. While the empirical recurrence risk of young contact athletes is already high, it can be further impaired by bony defects of the glenoid. In suspected cases, critical glenoid defects should be quantified by computed tomography (CT) scans and treated by bony augmentation of the glenoid. PMID:24604155

  1. Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation%肩关节镜下带线锚钉内固定治疗复发性肩关节前脱位

    Institute of Scientific and Technical Information of China (English)

    姜侃; 孙荣鑫; 钟广军

    2012-01-01

    Objective:To investigate the curative effect of arthroscopic glenoid labrum repair by biodegradable anchor fixation for recurrent anterior shoulder dislocation. Methods: Twenty-one patients of recurrent anterior shoulder dislocation with the average UCLA function score of 22. 3 ±4. 1 were treated with arthroscopic glenoid labrum repair by biodegradable anchor fixation. The shoulder was fixed by shoulder-elbow elastic band for 4 - 6 weeks and canonical exercise of shoulder joint was taken postoperatively. Results; The patients were followed up for 3-18 (mean 8) months; and the average UCLA score was 32. 3 ± 2. 6 postoperatively. The excellent results (34 -35) were obtained in 11 patients, good (28-33) in 7 patients and fair (21-27) in 3-'patients. The activity of shoulder joint was normal in all patients with an excellent subjective degree of satisfaction. Conclusion; Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation has the advantages of less invasiveness, simpler procedure , reliable fixation, less complications and rapid functional recovery.%目的:探讨肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位的疗效与方法.方法:本组21例复发性肩关节前脱位患者,肩关节功能评估采用美国加州洛杉矶大学UCLA功能评分标准,术前评分平均(22.3±4.1)分.全部采用肩关节镜下可吸收带线锚钉内固定修复盂唇损伤.术后肩肘固定带固定患肩4~6周,按规定程序进行康复锻炼.结果:经3~18个月(平均8个月)的随访,术后UCLA评分平均(32.3±2.6)分.优(34~35分)11例,良(28 ~ 33分)7例,中(21 ~27分)3例,无差病例.术后肩关节活动范围正常.患者主观满意度:均较满意.结论:肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位,具有创伤小、操作简便、内固定可靠、术后并发症少、功能恢复快等优点,是

  2. The influence of various resistance loads on the ratio of activity of the external rotator muscles of the shoulder and the anterior gliding of the humeral head during external rotation exercise.

    Science.gov (United States)

    Jo, Marg-Eun; Lee, Seung-Min; Jang, Jun-Hyeok; Lee, Sang-Yeol

    2015-10-01

    [Purpose] To quantify the ratio of activation of the infraspinatus and posterior deltoid muscles and the anterior gliding motion of the humeral head during external rotation (ER) motions of the shoulder performed in prone position against different external resistance loads. [Subjects] Twenty healthy women between the ages of 20 and 30 years. [Methods] Activity ratio was quantified as the difference in the root mean square of the smoothed electromyography signal (EMG) of the posterior deltoid to the infraspinatus muscle, and anterior gliding pressure of the humeral head using a pressure biofeedback unit (PBU), for three resistance loads: 0, 1 and 2 kg. [Results] There was a significant correlation among all three variables (load, ratio, and pressure). Anterior gliding pressure correlated with the activity ratio, with activity of the posterior deltoid increasing with the magnitude of the resistance load. [Conclusion] There was a positive association between the magnitude of resistance load, activity of the posterior deltoid and anterior gliding pressure of the humeral head. The PBU could be used to facilitate the recruitment of the infraspinatus muscle at higher loads to improve glenohumeral joint stability during ER exercise against higher resistance. PMID:26644683

  3. Shoulder Fractures

    Science.gov (United States)

    ... a Hand Therapist? Media Find a Hand Surgeon Shoulder Fractures Email to a friend * required fields From * ... can create difficulty with its function. Types of Shoulder Fractures The type of fracture varies by age. ...

  4. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    OpenAIRE

    Lacy, Kyle; Cooke, Chris; Cooke, Pat; Schupbach, Justin; Vaidya, Rahul

    2015-01-01

    Traumatic dislocations of the shoulder commonly present to emergency departments (EDs). Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of im...

  5. Shoulder pain

    Science.gov (United States)

    Pain - shoulder ... changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or ... The most common cause of shoulder pain occurs when rotator cuff tendons ... The tendons become inflamed or damaged. This condition ...

  6. Painful glenohumeral joint instability in athletes

    International Nuclear Information System (INIS)

    Instability of the glenohumeral joints is a common cause of chronic shoulder pain and disability in athletes using repetitive arm movements in elevation and external rotation. A series of 29 athletes with persistent shoulder discomfort for transient subluxation was evaluated with plain radiography and tomography in right axillary projection. The purpose was to detect abnormalities in the osseous glenoid rim. Twenty-six patients (89.6% of all cases studied) had various degrees of skeletal damage, including 18 fractures (69.2%) of the anterior rim, 2 (7.6%) of the posterior rim, and 6 cases (23.07%) of local degenerative changes; 3 cases were negative for skeletal damages. The results of this study demontrate conventional radiography to be useful in the diagnostic assessment of shoulder pain in athletes, where similar problems must be promptly detected and not ignored

  7. Hennipen 法治疗老年患者肩关节前脱位的临床疗效观察%Clinical effect of Hennipen method to treat elderly patients with anterior dislocation of the shoulder joint

    Institute of Scientific and Technical Information of China (English)

    陈孙裕; 肖展豪; 李坚

    2016-01-01

    Objective To analyze the clinical curative effect of Hennipen method to treat elderly patients with anterior dislocation of shoulder joint.Methods Between February 2013 and June 2015,57 elderly patients with acute anterior dislocation of shoulder joint were colleted in our hospital.The patients aged from 65 to 81,with average age of 72.3 years.Hennipen method was used to replace the dislocation of shoulder joint.Visual analogue scale (VAS)scores and joint range of motion before and after treatment were recorded to evaluate its clinical effect.Results All cases were checked with X -ray to comfirm had been reducted,and had no complications,such as proximal humeral fractures,axillary nerve injured.1 case failed maneuver reduction,so was tracted and reseted again after anesthesia.Before treatment,the VAS scores was (5.4 ±0.9)points,which after treatment was (1.9 ±0.7)points, and the difference was significant(t =12.43,P <0.01).The range of motion of the shoulder joint was significantly improved.Conclusion Hennipen method is simple,to threat anterior dislocation of shoulder joint of elderly patients, it can effectively relieve pain,reduce complications,which is worthy of clinical promotion.%目的:分析 Hennipen 法治疗老年患者肩关节前脱位的临床疗效。方法收集厦门大学附属福州市第二医院治疗的急性肩关节前脱位老年患者57例,年龄65~81岁,平均72.3岁。所有患者采用Hennipen 法复位肩关节,治疗前后记录肩关节活动度,采用疼痛视觉模拟量表(VAS)评分,评估其临床效果。结果所有患者行 X 线检查,证实整复成功,未出现肱骨近端骨折、腋神经损伤等并发症,1例复位失败,改麻醉下牵引复位。治疗前 VAS 评分为(5.4±0.9)分,治疗后 VAS 评分为(1.9±0.7)分,治疗前后 VAS 评分差异有统计学意义(t =12.43,P <0.01)。治疗后患者关节活动度均明显改善。结论Hennipen 法复

  8. Magnetic resonance imaging of the shoulder

    International Nuclear Information System (INIS)

    The technique of the own method of shoulder examination was presented. Anatomy and the most common diseases of the shoulder are discussed. The diseases of the shoulder diagnosed on the basis of the MR are: rotator cuff disease, impingement syndrome and instability. MR findings occurred in these entities were demonstrated. The most common MR finding of the rotator cuff disease was higher signal intensity within the supraspinatus tendon, while in shoulder instability was labral abnormality. Impingement syndrome is the previous syndrome of the full MR imaging of the rotator cuff disease. (author)

  9. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Directory of Open Access Journals (Sweden)

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  10. Latarjet两种术式治疗肩关节复发性前脱位伴重度骨缺损3~5年随访的比较研究%Comparison of two kinds of Latarjet procedures for recurrent anterior dislocation of the shoulder with severe glenoid bone defects:a 3-5 year follow-up study

    Institute of Scientific and Technical Information of China (English)

    向明; 杨国勇; 陈杭; 胡晓川; 唐浩琛

    2014-01-01

    Objective Shoulder dislocations,most of which are anterior dislocations,account for over 40% of joint dislocations.The main pathological mechanism is the dysfunction of the anteroinferior glenolabral articular ligamental complex,namely theBankart inj ury.Failure of the repair can cause the recurrent dislocation.Some cases are accompanied with the glenoidavulsion fracture or the bony defect,even with the inverted pear glenoid.Open or arthroscopic reconstruction can achieve excellent clinical results for the Bankart injury which bone defect is less than 25%.But if bony defect of glenoid is over 25%-30% or associtaed with Hill-Sachs injury,the re-dislocation rate is up to 67%after the simple Bankart reconstruction.The Latarj et procedure is able to reduce the recurrent dislocation significantly.This study is to retrospectively evaluate the three-to-five years'follow-up results of the Latarj et coracoid bone block procedure for the recurrent anterior dislocation of the shoulder associated with the severe bony defects.Methods Thirty-seven patients (23 men and 14 women)underwent the Latarjet procedure for the anterior glenohumeral instability between April 2006 and October 2009.All the shoulders had the severe osseous deficiency of the anterior glenoid rim, which was more than 25% of the glenoid width according to 3-dimensional CT scan and arthroscopic findings.The patients were associtated with Engaging Hill-Sachs lesion.21 patients were treated by the parallel coracoid transposition bone block from January 2008 to October 2009,and 16 patients were performed with the intorted coracoid transposition method from April 2006 to December 2007. Apprenhension sign was positive in all of the 37 patients before operation.And the mean time of their dislocations was 13.5 (ranged from 8 to 28 times).We evaluated the preoperative and postoperative pain,the daily living activities,the range of motion,stability of the shoulders,and function of the shoulder using the American Shoulder

  11. Shoulder impingement syndrome: MR findings in 53 shoulders

    OpenAIRE

    Seeger, LL; Gold, RH; Bassett, LW; Ellman, H

    1988-01-01

    The shoulder impingement syndrome refers to a condition in which the supraspinatus tendon and subacromial bursa are chronically entrapped between the humeral head inferiorly and either the anterior acromion itself, spurs of the anterior acromion or acromioclavicular joint, or the coracoacromial ligament superiorly. As a result, the space for the bursa and tendon is reduced, and repeated trauma to these structures leads to burstitis and rotator cuff injury. Although pain and limitation of moti...

  12. Shoulder Impingement Treatment

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Shoulder Impingement Treatment Page Content Article Body Shoulder impingement ... goals for shoulder impingement. Phases and Goals of Shoulder Impingement Treatment Treating shoulder impingement involves limiting activities ...

  13. Shoulder CT scan

    Science.gov (United States)

    CAT scan - shoulder; Computed axial tomography scan - shoulder; Computed tomography scan - shoulder; CT scan - shoulder ... stopping.) A computer creates separate images of the shoulder area. These are called slices. These images can ...

  14. Painful shoulder

    Directory of Open Access Journals (Sweden)

    Benno Ejnismann

    2008-03-01

    Full Text Available Many factors can be involved in the painful shoulder. Beyond articularcauses other pathologies such as artrosis, periarticular diseases as rotadorcuff tears, long head of the biceps tendinitis, adhesive capsulitis, calcifyingtendinitis, degenerative arthritis of the acromioclavicular joint, cervicalradiculopathy and nervous injuries can cause pain in the shoulder.

  15. Shoulder Arthroscopy

    Science.gov (United States)

    ... inflamed tissue or loose cartilage • Repair for recurrent shoulder dislocation Less common procedures such as nerve release, fracture repair, and cyst excision can also be performed using an arthroscope. ... as shoulder replacement, still require open surgery with more extensive ...

  16. Arthroscopic Bankart repair for treatment of recurrent anterior shoulder dislocation with Mitek bioknotless suture anchors%关节镜下非打结型缝合锚钉修补Bankart损伤治疗复发陛肩关节前脱位

    Institute of Scientific and Technical Information of China (English)

    黄华扬; 郑小飞; 张余; 尹庆水

    2008-01-01

    Objective To investigate the clinical results of arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation with Mitek bioknotless suture anchors.Methods Fourteen patients of recurrent anterior shoulder dislocation were treated by arthroscopic Bankart repair with Mitek bioknotless suture anchors.All patients had unidirectional instabilities on the dominant sides.The average age at surgery was 25.2 years (range,18-34 years).The mean times of dislocations before surgery were 13.5 (range,3-36).American Shoulder and Elbow Surgeons(ASES) and Constant-Murley score were adopted for final evaluation at the last follow-up.Results The mean follow-up period was 17 months (range,11-22 months).A Hill-Sachs lesion was observed in 9 patients.A bony Bankart lesion was found in 3 patients.A type Ⅱ SLAP lesion was associated in 2 patients and treated with arthroscopie fixation.A posterior-inferior labral lesion was found in 2 patients and treated with arthroseopic debridement.A joint mouse was removed in 1 patient.The mean forward flexion was 163.4°±8.6° and 169.7°± 4.2° pre-and postoperatively.The mean external rotation in 90° abduction was 58.5°±13.6° and 90.30°±5.5°pre-and postoperatively,which was less 8.40°±6.2° than that of normal side shoulder postoperatively.The pre-and postoperative mean ASES score was 77.4±3.7 and 94.3±2.6,the mean VAS instability score were 7.2±1.4 and 1.2±0.6.The pre-and postoperative mean Constant-Murley score was 78.1 ±4.6 and 93.9±3.7.All patients did not suffer postoperative s houlder dislocation.All patients returned to their pre-injury works.Conclusion Arthroseopic Bankart repair with Mitek bioknotless suture anchors is a good option for treating recurrent anterior shoulder dislocation.%目的 探讨关节镜下非打结型缝合锚钉修补Bankan损伤治疗复发性肩关节前脱位的疗效.方法 复发性肩关节前脱位患者14例,均为男性;年龄18~34岁,平均25.2岁;左侧4

  17. Tradução e adaptação cultural para o português do Brasil do western ontario shoulder instability index (WOSI

    Directory of Open Access Journals (Sweden)

    Gisele Barbosa

    2012-02-01

    Full Text Available INTRODUÇÃO: A instabilidade no ombro é um problema comum que afeta pacientes, mais frequentemente, na segunda e terceira décadas de vida e atletas que participam de esportes de arremesso ou de contato. Entre suas consequências estão dor, decréscimo no nível de atividade e um decréscimo geral na qualidade de vida. Muitos tratamentos têm sido propostos para os diversos tipos de instabilidade; entretanto, existem poucos instrumentos de avaliação que comprovem sua eficácia. Para utilização de medidas de avaliação em saúde desenvolvidas e utilizadas em outro idioma é necessário realizar a equivalência transcultural, sendo desnecessário criar e validar outro instrumento que avalie a condição de interesse. O objetivo deste estudo foi realizar a tradução e a adaptação cultural do questionário WOSI (The Western Ontario Shoulder Instability Index para a língua portuguesa do Brasil. MATERIAIS E MÉTODOS: O protocolo aplicado consistiu em: 1 preparação, 2 tradução, 3 tradução de volta à língua original (retrotradução, 4 interrogatório cognitivo, e 5 relato de informações. Ao serem concluídas as etapas de tradução e retrotradução, as versões foram enviadas para os autores do WOSI original, que aprovaram para continuação do estudo. A versão em português foi aplicada em 35 pacientes com instabilidade no ombro para verificar o nível de compreensão do instrumento. A versão brasileira final do WOSI foi definida após conseguir menos que 15% de "não compreensão" em cada item. Para análise das variáveis, foi utilizada estatística descritiva. RESULTADOS: Para obter a equivalência cultural foram realizadas modificações e alterações de termos sugeridas pelos pacientes para os itens "não compreendidos". CONCLUSÃO: Após a tradução e adaptação cultural do questionário, a versão em português do WOSI foi concluída.

  18. Avaliação dos resultados do tratamento cirúrgico artroscópico da luxação traumática anterior de ombro: primeiro episódio Assessment of the results from arthroscopic surgical treatment for traumatic anterior shoulder dislocation: first episode

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2012-04-01

    Full Text Available OBJETIVO: Avaliar os resultados dos pacientes submetidos ao tratamento cirúrgico artroscópico após o primeiro episódio de luxação traumática anterior do ombro. MÉTODOS: Entre agosto de 2000 e outubro de 2008, foram tratados 14 ombros de 14 pacientes pelo Grupo de Ombro e Cotovelo da Santa Casa de São Paulo. Treze (93% eram do sexo masculino e um (7% do sexo feminino; a idade variou de 17 a 41 anos, com média de 28 anos. Todos os pacientes avaliados eram praticantes regulares de alguma atividade esportiva (que exigem vigor físico dos membros superiores. O tempo entre o trauma e o tratamento cirúrgico variou de sete a 60 dias, com média de 20 dias. O procedimento cirúrgico foi realizado sob visualização artroscópica, com o paciente posicionado em decúbito lateral, sendo realizada a fixação do complexo lábio-ligamentar com a utilização de âncoras bioabsorvíveis. A avaliação pós-operatória foi realizada por meio do Rowe e da UCLA, e a mobilidade articular foi mensurada segundo as orientações da ASES. O tempo de seguimento pós-operatório variou de 24 a 120 meses, com média de 45 meses. RESULTADOS: Todos os pacientes obtiveram resultados satisfatórios (85% excelentes e 15% bons, conforme a UCLA, e 100% de resultados excelentes conforme o Rowe. O teste de apreensão foi negativo em todos os pacientes. CONCLUSÃO: O tratamento cirúrgico após o primeiro episódio de luxação traumática anterior do ombro parece ser uma boa opção terapêutica para pacientes jovens, ativos e praticantes de atividades esportivas.OBJECTIVE: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. METHODS: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93% were male and one (7% was female; their ages ranged

  19. Arthroscopic Reverse Remplissage for Posterior Instability.

    Science.gov (United States)

    Lavender, Chad D; Hanzlik, Shane R; Pearson, Sara E; Caldwell, Paul E

    2016-02-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a "reverse Hill-Sachs lesion." The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor-based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  20. Arthroscopic Reverse Remplissage for Posterior Instability

    Science.gov (United States)

    Lavender, Chad D.; Hanzlik, Shane R.; Pearson, Sara E.; Caldwell, Paul E.

    2016-01-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a “reverse Hill-Sachs lesion.” The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor–based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  1. Periarthritis of the shoulder-MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Hirano, Mako; Nomura, Kazutoshi; Hashimoto, Noburo; Fukumoto, Tetsuya; Oshima, Suguru; Katahira, Kazuhiro [Kumamoto National Hospital (Japan)

    1997-09-01

    We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

  2. Periarthritis of the shoulder-MRI findings

    International Nuclear Information System (INIS)

    We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

  3. Shoulder injuries in overhead sports

    International Nuclear Information System (INIS)

    Overhead sport places great demands on the shoulder joint. Shoulder pain in overhead athletes and throwers can in the majority of cases be attributed to lesions resulting from chronic overuse of tendons and capsuloligamentous structures or to sequels of microinstability and secondary impingement. Due to its great impact on therapeutic decisions, imaging in athletes with unclear shoulder pain is a challenge. In this connection, magnetic resonance (MR) arthrography represents the cross-sectional imaging modality of first choice, as it allows depiction and exclusion of pathologic alterations of all relevant joint structures with sufficient confidence. This article reviews the biomechanical and clinical aspects and MR arthrographic features of the most common shoulder pathologies in overhead athletes, including biceps tendinopathy, superior labral anterior-posterior (SLAP) lesions, rotator cuff lesions, as well as extrinsic and intrinsic impingement syndromes. (orig.)

  4. Infraglenoidal scapular notching in reverse total shoulder replacement: a prospective series of 60 cases and systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Hochreiter Josef

    2011-05-01

    Full Text Available Abstract Background The impact of infraglenoidal scapular notching in reversed total shoulder arthroplasty (RTSA is still controversially discussed. Our goal was to evaluate its potential influence on subjective shoulder stability and clinical outcome. We hypothesized that subjective instability and clinical outcome after implantation of RTSA correlates with objective scapular notching. Methods Sixty shoulders were assessed preoperatively and at minimum 2-year follow-up for active range of motion and by use of the Oxford instability score, Rowe score for instability, Constant score for pain, Constant shoulder score, DASH score. All shoulders were evaluated on anterior-posterior and axillary lateral radiographic views. These X-ray scans were classified twice by two orthopaedic surgeons with respect to infraglenoidal scapular notching according to the classification of Nerot. Notching was tested for correlation with clinical outcome scores to the evaluated notching. Results We found no significant correlation between infraglenoidal scapular notching and clinical outcomes after a mid-term follow-up from 24 to 60 months, but at the final follow-up of 60 months and more, we did see statistically significant, positive correlations between infraglenoidal scapular notching and the Constant pain score as well as active range of motion. At mean follow-up of 42 months (range from 24 to 96 months we found no significant correlation between subjective instability and infraglenoidal scapular notching. Conclusions We conclude that patients' subjective impression on their shoulders' stability is not correlating with radiological signs of infraglenoidal scapular notching. Nevertheless clinical parameters are affected by infraglenoidal scapular notching, at least in the long term

  5. Bilateral locked posterior shoulder dislocation in a footballer.

    OpenAIRE

    Ryan, J; Whitten, M

    1997-01-01

    Posterior dislocation of the shoulder is an uncommon injury, accounting for between 2% and 4% of all shoulder dislocations. It occurs most frequently in patients following convulsions or direct anterior force to the shoulder. It is a particularly uncommon injury in sport. This paper reports an unusual case of bilateal locked posteriorly dislocated shoulders in a previously healthy young man who fell while playing football.

  6. Shoulder replacement

    Science.gov (United States)

    ... are able to return to sports such as golf, swimming, gardening, bowling, and others. Your new shoulder ... important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy , ...

  7. Shoulder Problems

    Science.gov (United States)

    ... ibuprofen, for pain. No 11. Do you feel pain when you move your shoulder but there's no swelling or redness? Yes You may have BURSITIS or ROTATOR CUFF SYNDROME. Use an anti-inflammatory medicine, such as ibuprofen, ...

  8. CORRELATION ANALYSIS BETWEEN RECURRENT ANTERIOR SHOULDER DISLOCATION AND SECONDARY INTRA-ARTICULAR INJURIES%复发性肩关节前脱位与关节内继发损伤的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李海峰; 刘玉杰; 李众利; 李春宝; 董晓艳; 朱娟丽; 刘洋

    2012-01-01

    目的 通过分析肩关节前脱位次数、病程与关节内继发损伤的关系,探讨复发性肩关节前脱位对关节内继发损伤的影响. 方法 回顾分析2005年1月- 2009年6月关节镜下应用缝合锚钉行Bankart重建术治疗的59例复发性肩关节前脱位患者临床资料.男48例,女11例;年龄15~42岁,平均27.6岁.初次脱位原因:接触性体育运动21例,非接触性体育运动13例,日常活动11例,外伤14例.术前脱位3~32次,平均10.6次.初次脱位至手术时间为11个月~12年,中位时间5.9年.患者恐惧试验及复位试验均呈阳性.术前美国加州大学洛杉矶分校(UCLA)肩关节功能评分为(22.3±2.4)分,Constant-Murley评分为(73.1±5.8)分.关节镜下观察关节内继发损伤情况,并进行统计分析. 结果 术后患者切口均Ⅰ期愈合.患者均获随访,随访时间16~58个月,平均37.3个月.末次随访时,UCLA肩关节功能评分为(34.6±1.7)分,Constant-Murley评分为(86.7±6.1)分,与术前比较差异均有统计学意义(P<0.05).术前关节脱位次数和关节软骨损伤的严重程度成正相关(rs=0.345,P=0.007),和Hill-Sachs损伤严重程度成正相关(rs=0.708,P=0.000);首次脱位至手术时间和关节软骨损伤严重程度成正相关(rs=0.498,P=0.000),与Hill-Sachs损伤严重程度无相关性(rs=0.021,P=0.874). 结论 复发性肩关节前脱位早期行Bankart重建有利于肩关节功能恢复,避免或延缓关节内继发损伤的发生和发展.%Objective To explore the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries through analyzing the correlation between the number of dislocation, disease duration, and the secondary intra-articular injuries. Methods The clinical data were analyzed retrospectively from 59 patients with recurrent anterior shoulder dislocation who underwent arthroscopic Bankart reconstruction using suture anchor between January 2005 and June 2009. There were 48

  9. Resultados do procedimento artroscópico de "remplissage" na luxação anterior recidivante do ombro Results from filling "remplissage" arthroscopic technique for recurrent anterior shoulder dislocation

    OpenAIRE

    Mauro Emilio Conforto Gracitelli; Camilo Partezani Helito; Eduardo Angeli Malavolta; Arnaldo Amado Ferreira Neto; Eduardo Benegas; Flávia de Santis Prada; Augusto Tadeu Barros de Sousa; Jorge Henrique Assunção; Edwin Eiji Sunada

    2011-01-01

    OBJETIVO: Avaliar o resultado clínico da técnica de "remplissage" associada ao reparo da lesão de Bankart (BK) para o tratamento da luxação anterior recidivante do ombro. MÉTODOS: Nove pacientes (10 ombros), com seguimento médio de 13,7 meses, apresentaram luxação traumática anterior recidivante do ombro. Todos tinham lesão de BK associada à lesão de Hill e Sachs (HS), com sinal do "encaixe". O defeito das lesões de HS foi medido e apresentava em média 17,3% (7,7% a 26,7%) de perda óssea em r...

  10. Abduction and external rotation (ABER) MR arthrography of the shoulder. Benefits and limitations

    International Nuclear Information System (INIS)

    The purpose of this study was to show the benefits and limitations of using abduction and external rotation (ABER) positions of the arm during MR arthrography of the shoulder in the evaluation of the rotator-cuff tendon, the capsulolabral complex and the shoulder joint after surgery. Forty-seven patients complaining of either shoulder instability, chronic shoulder pain, pain of unknown cause or pain following shoulder surgery were studied using the direct MR arthrography technique in both the standard neutral position with the arm adducted as well as with the arm in the ABER position. A correlation was obtained between the MR arthrography findings and the surgical findings in 10 reports and clinical presentations of the examined patients. Three patients [6%] were unable to perform ABER positioning. ABER oblique axial images were better than standard oblique coronal images in revealing undersurface tears of the rotator cuff particularly of the grade I type. Four tears were missed in standard images. Oblique axial images were better than standard axial images in demonstrating non-displaced anterior labral tears. One tear was missed and two tears were suspected in the standard images. Oblique axial images were less sensitive than oblique coronal images in the diagnosis of superior labral tears. Two tears were missed in ABER images. The ABER oblique axial MR arthrogram is a useful adjunct to the standard axial and oblique coronal MR arthrograms for assessment of capsulolabral abnormalities and rotator-cuff tendon tears despite some limitations. (author)

  11. The primer for sports medicine professionals on imaging: the shoulder.

    Science.gov (United States)

    Farshad-Amacker, Nadja A; Jain Palrecha, Sapna; Farshad, Mazda

    2013-01-01

    Because of its inherent superior soft tissue contrast and lack of ionizing radiation, magnetic resonance imaging (MRI) is highly suited to study the complex anatomy of the shoulder joint, particularly when assessing the relatively high incidence of shoulder injuries in young, athletic patients. This review aims to serve as a primer for understanding shoulder MRI in an algorithmical approach, including MRI protocol and technique, normal anatomy and anatomical variations of the shoulder, pathologic conditions of the rotator cuff tendons and muscles, the long head of the biceps tendon, shoulder impingement, labral and glenohumeral ligament pathology, MR findings in shoulder instability, adhesive capsulitis, and osteoarthritis. PMID:24381700

  12. Study on the improved stimson with immobilization of external expansion and rotation in treatment primary traumatic anterior shoulder dislocation%悬垂踩踏整复法结合外展外旋位固定治疗初发性肩关节脱位40例

    Institute of Scientific and Technical Information of China (English)

    李志华; 丘青中

    2012-01-01

    Objective: To explore improved stimson used in curing the primary traumatic anterior shoulder dislocation while analysis its mechanism,and compare the effect of two immobilization methods of shoulder dislocation reduction. Methods: 80 patients with primary traumatic anterior shoulder dislocation successfully received a manual reduction with the improved stimon methods. All the cases were divided into two groups,Two methods for immobilization(external expansion and internal adduction rotation)were used.Shoulder function and recurrence rates were analyzed. Results:The UCLA score reflecting joint function showed no significant difference between the two groups(P>0.05).Recurrence rate of interna1 and external immobilization was 27.5% and 5%, respectively(P0.05).对照组复发率27.5%,治疗组复发率5.0%,两组比较,差异有统计学意义(P<0.01),且治疗组在并发肩关节病亦低于对照组(P<0.01).结论:悬垂踩踏整复法治疗初发性肩关节脱位符合解剖及生物力学原理,复位后外旋固定法较内旋固定复发率低,且利于关节功能恢复.

  13. Dislocated shoulder - aftercare

    Science.gov (United States)

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... You most likely dislocated your shoulder from a sports injury or accident, such as a fall. You have likely injured (stretched or torn) some of the muscles, ...

  14. Shoulder surgery - discharge

    Science.gov (United States)

    SLAP repair - discharge; Acromioplasty - discharge; Bankart - discharge; Shoulder repair - discharge; Shoulder arthroscopy - discharge ... You had shoulder surgery to repair the tissues inside or around your shoulder joint. The surgeon may have used a tiny ...

  15. Interobserver variation in reporting CT arthrograms of the shoulder

    International Nuclear Information System (INIS)

    Computed tomography (CT) arthrography of the shoulder is an imaging modality of great diagnostic accuracy with regard to glenohumeral instability and in particular labral lesions. Interpretation of the scans is made difficult by the frequent occurrence of normal anatomic variants and the complexity of injuries to the bone and soft tissues. We selected a continuous sample of 50 CT arthrograms of the shoulder and they were reported by two consultant musculoskeletal radiologists. The results were collated and analysed for the level of agreement. Hill–Sachs showed Kappa (K) statistic to be 0.37 (fair agreement), soft tissue Bankart 0.32 (fair agreement), bony Bankart 0.61 (substantial agreement), anterior capsular laxity 0.41 (moderate agreement) and glenohumeral osteoarthritis 0.20 (slight agreement). All the results were significant with a p value of <0.05. Nine (18%) of the 50 scans were in complete agreement. The results demonstrate that there can be considerable interobserver variation (IOV) in the reports of a CT arthrogram of a shoulder. They highlight the potential difficulties in reporting such images and suggests ways in which the report could be more focussed to provide a clinically reliable report and one which matches the surgical findings accurately.

  16. Multi-slice CT evaluation of glenoid bone loss in patients with recurrent anterior shoulder dislocation%多层螺旋CT评价复发性肩关节前方脱位的前方关节盂骨质缺损的临床意义

    Institute of Scientific and Technical Information of China (English)

    崔志新; 张悦; 郑卓肇; 任阿红

    2012-01-01

    目的 在复发性肩关节前方脱位中,利用MSCT评估关节盂前方骨质缺损情况.方法 回顾分析108例复发性肩关节前脱位和12例单次肩关节脱位患者的MSCT检查,对比评价前方关节盂骨质缺损的发生率、程度及位置.利用Fisher精确概率法分析前方关节盂骨质缺损的发生率,利用Wilcoxon秩和检验比较前方关节盂骨质缺损的上下长径、深度及比例.结果 在复发性肩关节前脱位中,91.7%(99/108)存在前方关节盂的骨质缺损,缺损比例为(16.0±6.0)%,缺损中心位置介于时钟分区的2:20~ 4:25点(平均3:20点),62.0%(67/108)前方出现骨性Bankart病变,包括游离型39例(58.2%)及黏附型28例(41.8%).12例单次肩关节脱位中,9例出现前方关节盂骨质缺损,其缺损发生率(9/12;P=0.100)和缺损比例[(15.2±7.1)%;P=0.453]与复发性肩关节脱位比较差异均无统计学意义.结论 前方关节盂骨质缺损为复发性肩关节前方脱位的常见表现.%Objective To evaluate multi-slice CT (MSCT) in glenoid bone loss of patients with recurrent anterior shoulder dislocation.Methods MSCT findings of 108 patients with recurrent anterior shoulder dislocation and 12 with single anterior shoulder dislocation were retrospectively studied.The incidence,degrees and locations of glenoid bone losses were recorded.The incidence was analyzed with Fisher exact test.The maximum length,depth and proportion were compared with Wilcoxon rank sum test.Results Glenoid bone loss was detected in 91.7% (99/108)patients with recurrent anterior shoulder dislocation.The proportion of glenoid bone loss was ( 16.0 ± 6.0)%,and the central locations of glenoid bone loss were from 2: 20 to 4: 25 ( mean 3: 20).Sixty-two percent (67/108) patients had bony Bankart lesions in which 58.2% (39/67) bony fragments were free and 41.8% (28/67) were adherent to the anterior border of the glenoid cavity.Seventy-five percent (9/12) patients with single

  17. Arthroscopic Shoulder Surgery in Female Professional Tennis Players

    Science.gov (United States)

    Young, Simon W.; Safran, Marc R.; Dakic, Jodie; Nguyen, Michael L.; Stroia, Kathleen

    2013-01-01

    Objectives: Recent publications have highlighted the relatively poor outcome of other overhead athletes, particularly baseball players, with regard to return to sports at the same or higher level after shoulder surgery. However, true assessment of their ability when returning to sport is not as clear. Further, ability to return to other overhead sports has not been reported. Our objective was to assess outcome and time to return to previous level of function following shoulder surgery in professional tennis players. Methods: The records of all female tennis players on the Women’s Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Details of the surgery including date, procedures performed, and complications were recorded. The primary outcomes were ability and time to return to professional play, and if they were able to return to their previous level of function, as determined by singles ranking. Pre and post-operative singles rankings were used to determine rate and completeness of return to preoperative function. Their highest ranking pre-injury, post operatively, and the time to return to pre-injury ranking were evaluated. Results: During the study period eight professional women tennis players from the WTA underwent shoulder surgery on their dominant arm. All surgery was performed arthroscopically, 7 out of 8 players had more than one procedure performed during the surgery. In total, 3 players underwent debridement of a partial rotator cuff tear and 2 players underwent repair of a complete supraspinatus tear. Three players had an anterior labral repair or reconstruction for anterior instability, and one player underwent repair of a SLAP lesion. Two players underwent neurolysis of a suprascapular nerve, and three players in total underwent a subacromial decompression. All players (100%) returned to professional play. The mean

  18. Shoulder biomechanics

    Energy Technology Data Exchange (ETDEWEB)

    Lugo, Roberto; Kung, Peter; Ma, C. Benjamin [Sports Medicine and Shoulder Service, University of California, San Francisco, 500 Parnassus Avenue, MU 320W-0728 San Francisco, CA 914143 (United States)], E-mail: maben@orthosurg.ucsf.edu

    2008-10-15

    The biomechanics of the glenohumeral joint depend on the interaction of both static and dynamic-stabilizing structures. Static stabilizers include the bony anatomy, negative intra-articular pressure, the glenoid labrum, and the glenohumeral ligaments along with the joint capsule. The dynamic-stabilizing structures include the rotator cuff muscles and the other muscular structures surrounding the shoulder joint. The combined effect of these stabilizers is to support the multiple degrees of motion within the glenohumeral joint. The goal of this article is to review how these structures interact to provide optimal stability and how failure of some of these mechanisms can lead to shoulder joint pathology.

  19. Reconstruction of the anterior cruciate ligament with the iliotibial band autograft in patients with chronic knee instability.

    Science.gov (United States)

    Jørgensen, U; Bak, K; Ekstrand, J; Scavenius, M

    2001-05-01

    We performed combined internal and external anterior cruciate ligament (ACL) reconstruction with the iliotibial band autograft in 169 consecutive patients with chronic ACL insufficiency who were followed up for 24-61 months. Of these, 155 (91%) agreed to an additional independent observer follow-up after 24-92 months. Eight patients (5%) had sustained a rerupture/elongation of the graft and were operated on again; nine (6%) had sustained a tear of the contralateral ACL. Knee function and activity increased after the reconstruction. Lysholm scores improved from median 81 preoperatively to 99 at follow-up and Tegner scores from median 4 to 7. At follow-up 97 (71%) were active at the same level as prior to injury. In 17 of the 40 patients (12%) dropping to a lower activity level this was due to knee problems. The side-to-side difference in anterior-posterior knee laxity was more than 3 mm in 18 knees (13%) and more than 5 mm in 3 knees (2%). Including eight reruptures, this results in a "stability" failure rate of 8.8%. The overall IKCD rating showed normal knee function in 88 (73%) and nearly normal knee function in 30 (25%). Anterior knee pain was present in 14 (10%) of the patients at follow-up. Patients with isolated ACL injury had higher Lysholm scores and Tegner scores than patients with associated injuries. No clinical signs of varus knee development were seen. Of the 155 patients 94% would have the procedure repeated if necessary with the knowledge that they have today. The combined internal and external iliotibial band procedure can restore knee stability and function in the majority of chronic ACL-insufficient knees. PMID:11420786

  20. Reducing Shoulder by Vertical Traction: A One-Man Method for Shoulder Reduction

    Directory of Open Access Journals (Sweden)

    Hayat Ahmad Khan

    2016-01-01

    Full Text Available Fifty percent of joint dislocations reported to the emergency department are of shoulder joint. Various techniques are used to reduce the shoulder and Spaso technique is the least known to the orthopaedic residents which is a simple one-man vertical traction method of shoulder reduction. We evaluated the effectiveness of vertical traction method for anterior shoulder dislocation by orthopaedic residents. Sixty consecutive patients of anterior glenohumeral dislocation attending the emergency department of our hospital were taken up for the study. The reduction was done using Spaso technique. Right shoulder was dislocated in 40 patients and 31 patients had recurrent shoulder dislocation. In 55 patients, shoulder was reduced without the use of any anaesthesia. In patients where no anaesthesia was used, the time of traction ranged from 45 seconds to 5 minutes, while under anaesthesia the time of traction ranged from 1 to 4 minutes. Twenty-one patients had associated greater tuberosity fracture which did not affect the method of reduction and all of them were reducible. No complication was reported, and all the patients were satisfied with the method. In conclusion vertical traction method is a good technique for reducing anterior shoulder dislocation with an easy learning curve among the residents and no complication has been reported so far.

  1. Frozen shoulder: a sympathetic dystrophy?

    Science.gov (United States)

    Müller, L P; Müller, L A; Happ, J; Kerschbaumer, F

    2000-01-01

    Diagnostic and clinical features of the frozen shoulder syndrome and the Sudeck syndrome are similar in many aspects. Radioisotope bone scan shows an increased uptake in affected areas in both diseases, while native radiographs show a progressive demineralisation. Measurement of bone mineral density (BMD) by quantitative digital radiography objectified these local decalcification processes in an early stage of the frozen shoulder syndrome; 10 of 12 patients with primary frozen shoulder had BMD decreases greater 21% in the humeral head of the affected shoulder compared to the non-affected side. In the immobilised control group with degenerative changes of the rotator cuff, calcifying tendinitis and shoulder instability (n = 12) and in the group of healthy probands (n = 20), the difference between the affected and non-affected side (left and right humerus of the healthy probands) was only more than 21% in one case each. There are several references in the literature that assume frozen shoulder to be an algoneurodystrophic process; our observations support this hypothesis, possibly leading to earlier diagnoses and extended therapeutic management. PMID:10653111

  2. Diagnosis of Hill-Sachs lesion of the shoulder. Comparison between ultrasonography and arthro-CT

    International Nuclear Information System (INIS)

    Aim: The Hill-Sachs lesion is a compression fracture caused by impact on the trabe-culae of the humeral head during anterior glenohumeral dislocation. The early and accurate identification of patients who risk recurrence of shoulder dislocation requires a suitable screening method. This should be characterized by high sensitivity and specificity, low cost, and repeatability. Material and Methods: The results of ultrasound examination as a screening method were evaluated, the indicator being the identification of the Hill-Sachs lesion. Using ultrasonography and conventional radiological techniques, and double contrast CT (arthro-CT), we studied 60 patients with posttraumatic instability of the shoulder. Results: Against arthro-CT as the true standard, ultrasonography showed a sensitivity of 95.6%, specificity of 92.8%, and diagnostic accuracy of 95%. (orig.)

  3. A Shoulder Health Survey

    OpenAIRE

    Kane, Steven; Conus, Sean; Haltom, Douglas; Hirshorn, Kurt; Pak, Youngju; Vigdorchik, Jonathan

    2010-01-01

    Shoulder pain and loss of shoulder function are common complaints reported by a variety of patients. This article suggests that shoulder pain and loss of function are directly proportional to lifestyle choices, including smoking and obesity. To investigate possible relationships between lifestyle choices and shoulder health, the authors conducted an online survey combining the Oxford Shoulder Questionnaire, the Shoulder Rating Questionnaire, and the Subjective Shoulder Rating System. Data wer...

  4. Shoulder pain

    OpenAIRE

    Dorinson, S. Malvern

    2010-01-01

    “Topics in Primary Care Medicine” presents articles on common diagnostic or therapeutic problems (such as dizziness, pruritus, insomnia, shoulder pain and urinary tract infections) encountered in primary care practice that generally do not fall into well-defined subspecialty areas and are rarely discussed thoroughly in medical school, house staff training, textbooks and journals. Often the pathophysiology is poorly understood and clinical trials to assess the effectiveness of diagnostic tests...

  5. 制动方法对初发肩关节脱位术后脱位复发率和生活质量改善情况的荟萃分析%External rotation immobilization does not reduce recurrence rate or improve quality of life after primary anterior shoulder dislocation:the result of a meta analysis

    Institute of Scientific and Technical Information of China (English)

    马驰原; 刘安; 严世贵

    2015-01-01

      结论:根据本研究的结果,与内旋制动相比,外旋制动在降低初次肩关节脱位术后的脱位复发率和提高患者的术后生活质量方面均无明显优势。%Background:Shoulder dislocations, especially anterior shoulder dislocation, are common injuries in our daily life. But the choice of external rotation or internal rotation immobilization remains controversial. Objective:To evaluate the rate of recurrence and patient-based quality-of-life after external rotation (ER) versus internal ro-tation (IR) immobilization in primary anterior shoulder dislocation by a meta-analysis. Methods:The PubMed, EMBASE, Cochrane Library and ISI Web of Science were searched up to January 2013, using the Boolean operators as follows:(Bankart lesion OR shoulder anterior dislocation) AND (external rotation AND internal rota-tion OR immobilization). All prospective randomized controlled trials (RCTs) directly comparing recurrence rate and pa-tient-based quality-of-life between ER and IR immobilization were retrieved. All data were conducted with STATA 11.0. Results:Seven RCT studies involving 663 patients (338 in ER group and 325 in IR group) were included in the meta analy-sis. No significant difference was observed in the recurrence rate in different age groups (in all patients:risk ratio [RR]=0.65, 95% confidence interval [CI]: 0.41-1.03, P=0.067; in the patients aged less than 30 years: RR=0.70, 95%CI: 0.38-1.29, P=0.250;in the patients aged more than 30 years:RR=0.86, 95%CI:0.38-1.97, P=0.722). In four trials assessing quali-ty-of-life after ER or IR immobilization, only one demonstrated borderline statistical significance (P=0.05) and probable su-periority of the ER group based on the ASES. No significant difference was observed in other three trials. Conclusions:Based on the results of our analysis, the ER immobilization cannot reduce the rates of recurrence after primary anterior shoulder dislocation or improve the quality of life compared

  6. Impingement syndrome of the shoulder; Schulterimpingement

    Energy Technology Data Exchange (ETDEWEB)

    Mayerhoefer, M.E. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung Radiodiagnostik fuer chirurgische Faecher, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet, Waehringer Guertel 18-20, 1090, Wien (Austria); Breitenseher, M.J. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Waldviertelklinikum Horn (Austria)

    2004-06-01

    The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.) [German] Das Impingementsyndrom ist ein klinisches Krankheitsbild multifaktorieller Genese, bei dem es primaer oder sekundaer zu einer schmerzhaften mechanischen Beeintraechtigung der Rotatorenmanschette kommt. Als primaere Faktoren gelten ein gebogener oder hakenfoermiger Vorderrand des Akromions oder von diesem entspringende Osteophyten, was zu Laesionen der Supraspinatussehne fuehren kann. Zu den sekundaeren Faktoren zaehlt man v. a. eine Tendinitis calcarea, eine glenohumerale Instabilitaet, ein Os acromiale sowie degenerative Veraenderungen im Bereich des Akromioklavikulargelenks. Bildgebend steht an erster Stelle ein Nativroentgen, mit dem sich die knoechernen Strukturen gut darstellen lassen. Falls vorhanden, kann in weiterer Folge die Sonographie Auskunft ueber den Zustand der Rotatorenmanschette geben. Mit der MRT schliesslich laesst sich die Beziehung von Akromion und gelenkassoziierten Strukturen zur Rotatorenmanschette

  7. Has the management of shoulder dislocation changed over time?

    OpenAIRE

    Chalidis, Byron; Sachinis, Nick; Dimitriou, Christos; Papadopoulos, Pericles; Samoladas, Efthimios; Pournaras, John

    2006-01-01

    Anterior shoulder dislocation is a disabling injury affecting all ages, young and old alike. Recently, the treatment of traumatic shoulder dislocation has included immobilisation for varying periods of time followed by physiotherapy. This study is the first in this country to address the demographic data and recurrence rates of shoulder dislocation. Three hundred and eight patients (170 men and 138 women) were followed up for an average of 5.9 years. The most frequent mechanism of injury was ...

  8. Intra-articular Lidocaine Injection for Shoulder Reductions

    OpenAIRE

    Waterbrook, Anna L; Paul, Stephen

    2011-01-01

    Context: The shoulder is the most commonly dislocated joint, and shoulder dislocations are very common in sports. Many of these dislocations present to the office or training room for evaluation. Usual practice is an attempt at manual reduction without analgesia and then transfer to the emergency department if unsuccessful. The clinical efficacy of intra-articular lidocaine for reduction of anterior shoulder dislocations in the outpatient setting was examined. Evidence Acquisition: An OVID ME...

  9. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... by almost ten years, is shoulders. So by definition, the average shoulder-replacement patient is almost ten ... DOUGLAS BOARDMAN III, MD: Exactly. Choices -- selection of primary versus reverse shoulder arthroplasty. 00:51:24 GERALD ...

  10. Dislocated shoulder - aftercare

    Science.gov (United States)

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  11. Shoulder separation - aftercare

    Science.gov (United States)

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... Shoulder separation is not an injury to the main shoulder joint itself. It is an injury to ...

  12. Milwaukee shoulder syndrome.

    OpenAIRE

    Somashekar SA

    1991-01-01

    Milwaukee shoulder syndrome or rapid destructive arthritis of the shoulder is a very rare rheumatological condition characterized by the deposition of hydroxyapatite crystals. The figure 1 shows the shoulder image of a 67-year-old female with a history of bilateral shoulder pain and swelling since 2 years and knee pain since 6 months. Physical examination revealed restriction in shoulder movements. No neurological deficit was reported. X-ray of the right shoulder indicated rotator cuff disrup...

  13. Concept of healing of recurrent shoulder dislocation.

    Science.gov (United States)

    D'Angelo, Donato

    2014-01-01

    This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others. The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases. Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical-pathological lesions, without considering the so-called essential lesions. The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique. Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles. PMID:26229839

  14. Shoulder Injuries and Disorders

    Science.gov (United States)

    ... of many common problems. They include sprains, strains, dislocations, separations, tendinitis, bursitis, torn rotator cuffs, frozen shoulder, fractures and arthritis. Usually shoulder problems are treated ...

  15. Hip instability.

    Science.gov (United States)

    Smith, Matthew V; Sekiya, Jon K

    2010-06-01

    Hip instability is becoming a more commonly recognized source of pain and disability in patients. Traumatic causes of hip instability are often clear. Appropriate treatment includes immediate reduction, early surgery for acetabular rim fractures greater than 25% or incarcerated fragments in the joint, and close follow-up to monitor for avascular necrosis. Late surgical intervention may be necessary for residual symptomatic hip instability. Atraumatic causes of hip instability include repetitive external rotation with axial loading, generalized ligamentous laxity, and collagen disorders like Ehlers-Danlos. Symptoms caused by atraumatic hip instability often have an insidious onset. Patients may have a wide array of hip symptoms while demonstrating only subtle findings suggestive of capsular laxity. Traction views of the affected hip can be helpful in diagnosing hip instability. Open and arthroscopic techniques can be used to treat capsular laxity. We describe an arthroscopic anterior hip capsular plication using a suture technique. PMID:20473129

  16. Synovial cutaneous fistula complicating a reverse total shoulder arthroplasty.

    Science.gov (United States)

    Letter, Haley P; Limback, Joseph; Wasyliw, Christopher; Bancroft, Laura; Scherer, Kurt

    2016-06-01

    Reverse total shoulder arthroplasty is becoming a common form of shoulder arthroplasty that is often performed in the setting of rotator cuff pathology. Infection is a rare complication but is more common in reverse total shoulder arthroplasty than in hemiarthroplasty or anatomic total shoulder arthroplasty. We present the case of a 69-year-old patient with a reverse total shoulder arthroplasty who presented with purulent drainage from the skin of his anterior shoulder. Computed tomography arthrogram confirmed the presence of a synovial cutaneous fistula. Synovial cutaneous fistula is a rare variant of periprosthetic infection that, to our knowledge, has not been described previously in the setting of a reverse total shoulder arthroplasty. Computed tomography arthrogram proved to be a reliable method for confirming the diagnosis and was used for operative planning to remove the hardware. PMID:27257460

  17. MRI of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, M.

    2000-02-01

    Shoulder imaging is one of the major applications in musculoskeletal MRI. In order to analyze the images it is important to keep informed about anatomical and pathological findings and publications. In this article MRI technique, anatomy and pathology is reviewed. Technical considerations about MR sequences and examination strategy are only shortly discussed with emphasis on turbo spin echo and short T1 inversion recovery imaging. Basic anatomy as well as recent findings, including macroscopic aspects of the supraspinatus fat pad, composition of the supraspinatus muscle belly, and variability of the glenohumeral ligaments or coracoid ligament, are presented. Basic pathological conditions are described in detail, e. g. instability particularly problems in differentiating the various subtypes of labral pathology. Rotator cuff diseases are elucidated with emphasis on some rarer entities such as subscapularis calcifying tendinitis, coracoid impingement, chronic bursitis producing the double-line sign, prominent coraco-acromial ligament and the impingement due to an inflamed os acromiale. (orig.)

  18. MRI of the shoulder

    International Nuclear Information System (INIS)

    Shoulder imaging is one of the major applications in musculoskeletal MRI. In order to analyze the images it is important to keep informed about anatomical and pathological findings and publications. In this article MRI technique, anatomy and pathology is reviewed. Technical considerations about MR sequences and examination strategy are only shortly discussed with emphasis on turbo spin echo and short T1 inversion recovery imaging. Basic anatomy as well as recent findings, including macroscopic aspects of the supraspinatus fat pad, composition of the supraspinatus muscle belly, and variability of the glenohumeral ligaments or coracoid ligament, are presented. Basic pathological conditions are described in detail, e. g. instability particularly problems in differentiating the various subtypes of labral pathology. Rotator cuff diseases are elucidated with emphasis on some rarer entities such as subscapularis calcifying tendinitis, coracoid impingement, chronic bursitis producing the double-line sign, prominent coraco-acromial ligament and the impingement due to an inflamed os acromiale. (orig.)

  19. Floating shoulder

    Directory of Open Access Journals (Sweden)

    B. de Pablo Márquez

    2014-09-01

    Full Text Available La fractura concomitante de clavícula y escápula es una entidad poco frecuente que puede ser una de las causas de afectación del complejo suspensorio del hombro también denominado hombro flotante (floating shoulder. Se relaciona frecuentemente con traumatismos de alta energía. Presentamos un caso de esta patología en un paciente varón de 28 años que consultó por caída en bicicleta con contusión sobre hombro izquierdo. Se describen las diferentes opciones terapéuticas planteadas, las imágenes radiológicas y una revisión de la literatura.

  20. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... by almost ten years, is shoulders. So by definition, the average shoulder-replacement patient is almost ten ... Anatomic Total Shoulder surgery, which featured the latest innovation in shoulder surgery from DePuy Orthopedics. OR-Live ...

  1. A Biomechanical Model Correlating Shoulder Kinetics to Pain in Young Baseball Pitchers

    OpenAIRE

    Keeley, David W.; Oliver, Gretchen D.; Dougherty, Christopher P.

    2012-01-01

    Previous work has postulated that shoulder pain may be associated with increases in both peak shoulder anterior force and peak shoulder proximal force. Unfortunately these relationships have yet to be quantified. Thus, the purpose of this study was to associate these kinetic values with reported shoulder pain in youth baseball pitchers. Nineteen healthy baseball pitchers participated in this study. Segment based reference systems and established calculations were utilized to identify peak sho...

  2. The clinical effect of reposition by manual reduction at different postures in 70 patients with anterior dislocation of shoulder joint%不同体位手牵足蹬法治疗肩关节前脱位70例临床疗效

    Institute of Scientific and Technical Information of China (English)

    姚丽; 应盛国

    2015-01-01

    Objective: To observe the clinical effect of reposition by manual reduction at different postures in patients with the primary anterior dislocation of shoulder joint.Methods:Seventy patients with the primary anterior dislocation of shoulder joint were collected and divided into a prone position group with 35 cases and a supine position one with 35 ones according to the different postures. The treatment effects of two groups were evaluated with the reference of the standard of shoulder joint reposition.Results: The reposition rate without anesthetic and total reposition rate were 71.43% (25/35) and 94.29% (33/35) in the prone position group and 62.86% (22/35) and 80.00% (28/35) in the supine group. The difference between two groups had the statistical signiifcance (P<0.05).Conclusion: In the treatment of anterior dislocation of shoulder joint, the effect of Hippocrates (manual reduction) is obviously better in the prone posture than in the supine posture.%目的:观察不同体位手牵足蹬法治疗原发性肩关节前脱位的临床疗效.方法:收集原发性肩关节前脱位患者70例,根据不同体位分为俯卧位手牵足蹬法复位治疗(俯卧位组)35例和仰卧位手牵足蹬法复位治疗(仰卧位组) 35例.参照肩关节复位标准评价两组疗效.结果:观察组无麻药复位率为71.43%(25/35),总复位率为94.29%(33/35);对照组无麻药复位率为62.86%(22/35),总复位率为80.00%(28/35),组间差异有统计学意义(P<0.05).结论:俯卧位手牵足蹬法治疗肩关节前脱位疗效优于仰卧位手牵足蹬法.

  3. MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    Full text: MR arthrography is a minimal invasive method, where first contrast media (CM) is applied intraarticular under fluoroscopic guidance and then MR examination is performed. the well-distended joint and the CM entering through the damaged structures enhance greatly the diagnostic capabilities of the method. Learning objectives: to present the technical aspects of performing MR arthrography of the shoulder; to outline the advantages and indications of the method; to demonstrate the normal variants and some of the most common pathological findings seen on MR arthrography of the shoulder. The shoulder joint pathologies are very heterogeneous in nature. Rotatory cuff and labral tears present major portion of the pathology seen in athletes and elderly people with degenerative changes. MR arthrography significantly improves the depiction of complete and partial tears of the rotatory cuff and damages to the capsular ligamentous complex and the glenoid labrum. The method also helps differentiating some normal variants from traumatic injuries. MR arthrography is affirming as golden standard for the investigation of patients with shoulder instability and surpasses conventional MRI examination in the diagnosis of partial rotatory cuff tears and labral tears

  4. To Observe the Clinical Effect of Stimson Reduction Method Cooperate with Zhuang Medicated Thread Moxibustion in Treating Adults with Acute Anterior Dislocation of Shoulder Joint%Stimson复位法配合壮医药线点灸治疗青壮年肩关节前脱位疗效观察

    Institute of Scientific and Technical Information of China (English)

    于小中; 洪定钢; 王效柱

    2013-01-01

    Objective:To observe the clinical effect of Stimson reduction method cooperate with Zhuang medicated thread moxibus-tion in treating adults with acute anterior dislocation of shoulder joint. Methods:36 cases of patients with Stimson reduction method are reset, and cooperate with Zhuang medicated thread moxibustion therapy in the treatment of intraoperative and postoperative. Re-sults:36 patients were all one-time success, with no use of anesthesia, patients were followed up for 6 months, the shoulder joint function of the patients recovered well, the total efficiency was 100%. Conclusion:Using Stimson reduction method cooperate with Zhuang medicated thread moxibustion in treating adults with acute anterior dislocation of shoulder joint is simple and effective, avoiding the use of anesthesia, and worth further clinical application.%  目的:观察Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位的临床疗效。方法:对36例青壮年急性肩关节前脱位采用Stimson复位法进行复位,并在术中及术后配合患肩壮医药线点灸治疗。结果:36例患者全部一次性复位成功,无一例使用麻醉,随访半年,患者肩关节功能均恢复良好,总有效率100%。结论:采用Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位操作方法简单,疗效肯定,避免了使用麻醉,值得临床进一步推广应用。

  5. Shoulder dislocation in patients older than 60 years of age

    Directory of Open Access Journals (Sweden)

    Rapariz Jose

    2010-01-01

    Full Text Available Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test and by imaging testing (X-ray, MRI. Results: Nine (31.03% out of 29 patients had a recurrent dislocation. Four of them required reconstructive surgery to maintain joint stability. Injury to the anterior support (anterior labrum, anterior glenoid rim showed a statistically significant relation to the recurrence of dislocations. The occurrence or non-occurrence of a rotator cuff tear does have an impact on the shoulder function. The degree of rotator cuff involvement on the coronal plane does not significantly affect the shoulder′s functional outcome. The tear extension on the sagittal plane does cause impairment on the Constant test. Conclusions: Labrum and/or anterior glenoid involvement should be suspected in elderly patients presenting with recurrent shoulder dislocation. Recurrence is due to an injury in the anterior support or both (anterior and posterior, even though shoulder function gets impaired when a rotation cuff tear occurs with anterior extension on the sagittal plane. Evidence level: IV Case series.

  6. Return to Play After Shoulder Stabilization in National Football League Athletes

    OpenAIRE

    White, Matthew J.; Fleisig, Glenn S.; Aune, Kyle; Andrews, James R.; Dugas, Jeffrey R.; Cain, E. Lyle

    2014-01-01

    Objectives: Shoulder instability is a common and limiting injury to football players. The return to play (RTP) percentage and factors affecting RTP after shoulder stabilization in National Football League (NFL) players are not defined. The purpose of this study was to determine the rate of return to professional football play in the NFL after shoulder stabilization and to determine what factors may affect RTP in these athletes. Methods: Sixty NFL players who had undergone shoulder stabilizati...

  7. Using your shoulder after surgery

    Science.gov (United States)

    Shoulder surgery - using your shoulder; Shoulder surgery - after ... You had surgery on your shoulder to repair a muscle, tendon, or cartilage tear. The surgeon may have removed damaged tissue. You will need to know how ...

  8. What Are Shoulder Problems?

    Science.gov (United States)

    ... tears are severe. Rotator Cuff Disease: Tendinitis and Bursitis In tendinitis of the shoulder, tendons become inflamed ( ... from being pinched by parts around the shoulder. Bursitis occurs when the bursa—a small fluid-filled ...

  9. Frozen shoulder - aftercare

    Science.gov (United States)

    ... shoulder level. Store food in cupboards, drawers, and refrigerator shelves that are between your waist and shoulder level. Get help with housecleaning, taking out the garbage, gardening, and other household tasks.

  10. Anatomic Total Shoulder System

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    Full Text Available ... 10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient care. In a few moments, ... by almost ten years, is shoulders. So by definition, the average shoulder-replacement patient is almost ten ...

  11. Anatomic Total Shoulder System

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    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: ... you'll be able to watch a live global AP anatomic total shoulder surgery from Methodist Hospital ...

  12. Reverse Shoulder Arthroplasty

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    Full Text Available ... case of reverse shoulder arthroplasty for cuff deficient arthritis. You should be aware that I helped design ... in the last decade for cuff deficient shoulder arthritis in the United States. The indications are a ...

  13. Inflamed shoulder tendons (image)

    Science.gov (United States)

    Tearing and inflammation of the tendons of the shoulder muscles can occur in sports which require the ... pitching, swimming, and lifting weights. Most often the shoulder will heal if a break is taken from ...

  14. Shoulder Problems in Athletes.

    Science.gov (United States)

    Clancy, William G., Jr.

    A description is given of typical sport-related injuries to the shoulder area. These include: (1) brachial plexus injuries; (2) peripheral nerve injuries about the shoulder; (3) acromioclavicular injuries; (4) sternoclavicular injuries; (5) shoulder dislocations; (6) recurrent traumatic subluxation/dislocations; and (7) overuse injuries.…

  15. "Floating shoulder" injuries.

    Science.gov (United States)

    Heng, Kenneth

    2016-12-01

    "Floating shoulder" is a rare injury complex resulting from high-energy blunt force trauma to the shoulder, resulting in scapulothoracic dissociation. It is commonly associated with catastrophic neurovascular injury. Two cases of motorcyclists with floating shoulder injuries are described. PMID:26961729

  16. Concept of healing of recurrent shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Donato D'Angelo

    2014-08-01

    Full Text Available This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others.The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases.Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical–pathological lesions, without considering the so-called essential lesions.The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique.Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles.

  17. The painful shoulder

    International Nuclear Information System (INIS)

    The painful shoulder syndrome is very common. Diagnosis and differential diagnosis may be difficult. Shoulder pain may be caused by local processes or systemic diseases or can be referred. Periarthritis humeroscapularis (frozen shoulder) is the most common cause of painful shoulder syndrome. Biomechanical factors concerning the rotator cuff are involved in the etiopathogenesis of these pain syndromes. The therapy of frozen shoulder includes physical treatment, antirheumatic drugs, or X-ray treatment. Surgical measures may become necessary. In the course of rheumatoid arthritis the shoulder may be involved. Milwaukee-shoulder-syndrome has been described recently in crystal deposit diseases. Shoulder pain may be referred by mechanical irritations of nerve roots in the course of degenerative lesions of the cervical spine and also in the course of internal diseases of the heart, the lungs, or the gastrointestinal tract. In cases of shoulder pain without pathological data from arthrological, radiological or laboratory studies, one should always consider localized fibromyalgia in the shoulder-neck-region. The precise diagnosis of shoulder pain is an important prerequisite for treatment, the success of which should not be judged as pessimistic as it has been commonly done in the past. (orig.)

  18. Magnetic resonance imaging (MR) of the shoulder

    International Nuclear Information System (INIS)

    In order to test the criteria for abnormalities of the shoulder as seen on MR, 30 normal shoulders were examined. The examination included T1, proton and T2-weighted SE sequences and T2*-weighted FE sequences, using transverse, oblique coronary and oblique sagittal planes. In 57% there was increased signal intensity in the tendon of the rotator cuff; this might have been interpreted as a rupture of the cuff or tendinitis. Anatomical examination suggests that the finding is due to a normal layer between the long head of the biceps and the tendon joint complex. The anterior glenoid labrum could not be clearly delineated in 57% and the posterior labrum in 5%. In two cases there was a superior, postero-lateral defect in the head of the humerus. The currently accepted criteria for the MRT diagnosis of shoulder abnormalities need to be critically re-evaluated. (orig.)

  19. Shoulder pain in primary care: frozen shoulder.

    Science.gov (United States)

    Cadogan, Angela; Mohammed, Khalid D

    2016-03-01

    BACKGROUND AND CONTEXT Frozen shoulder is a painful condition that follows a protracted clinical course. We aim to review the management of patients with a diagnosis of frozen shoulder who are referred for specialist orthopaedic evaluation against existing guidelines in primary care. ASSESSMENT OF PROBLEM Referrals and clinical records were reviewed for all patients referred for orthopaedic specialist assessment who received a specialist diagnosis of frozen shoulder. Diagnostic, investigation and management practices from a regional primary health care setting in New Zealand were compared with guideline-recommended management. RESULTS Eighty patients with frozen shoulder were referred for orthopaedic evaluation in the 13 month study period, mostly from general practice. Fifteen patients (19%) were identified as having a frozen shoulder in their medical referral. Most (99%) had received previous imaging. Seven patients (12%) had received guideline recommended treatment. STRATEGIES FOR IMPROVEMENT Education of all clinicians involved in patient management is important to ensure an understanding of the long natural history of frozen shoulder and provide reassurance that outcomes are generally excellent. HealthPathways now include more information regarding diagnosis, imaging and evidence-based management for frozen shoulder. LESSONS Frozen shoulder may be under-diagnosed among patients referred for orthopaedic review. Ultrasound imaging is commonly used and may identify occult and unrelated pathology in this age-group. When managed according to clinical guidelines, patients report significant clinical and functional improvement with most reporting 80% function compared with normal after 1 year. KEYWORDS Adhesive capsulitis; bursitis; injections; practice guideline; primary health care; ultrasound. PMID:27477374

  20. 先单纯肩关节前脱位复位后评定疗效4种评分量表的比较研究%Comparison of four scoring scales in functional evaluation of anterior shoulder after reduction for simple join dislocation

    Institute of Scientific and Technical Information of China (English)

    贾雪峰; 毕擎; 方基石; 林格生; 王之宇; 吴志勇

    2014-01-01

    Objective To compare four scoring scales in functional evaluation of anterior shoulder after reduction for simple joint dislocation. Methods One hundred patients with simple anterior shoulder join dislocation, including 48 males and 52 females with a mean age of 42.3y (21~54y), underwent reduction procedure under brachial plexus block. The CMS (Constangt- Murley score), Rowe score, UCLA (University of California at Los Angeles scale), ASES (rating scale of the American shoulder and elbow surgeons) were used to evaluate shoulder function and SF- 36 was used to assess the quality of life on 3 months after reduction, and the second evaluation with the same scales were performed 1 week later. Results The Cronbach's Alpha values of CMS, Rowe score, UCLA and ASES were 0.871, 0.765, 0.766 and 0.822, respectively. The intra- class correlation coefficient of CMS, Rowe score, UCLA and ASES were 0.918, 0.430, 0.772 and 0.970(P<0.05). The correlation coefficients of CMS, Rowe score, UCLA and ASES with SF- 36 were 0.841, 0.737, 0.665 and 0.912, respectively(P<0.05). Conclusion The performance of ASES for ante-rior shoulder function evaluation is relatively good, but lacks specificity for overal shoulder joint assessment. More balanced sub-jective and objective scales are needed for functional evaluation of anterior shoulder dislocation after joint reduction.%目的:分析4种肩关节评分量表评估肩关节前脱位功能的稳定性和可靠性。方法纳入两家医院共100例符合标准的肩关节前脱位患者,男48例,女52例;平均42.3岁(21~54岁)。均臂丛麻醉下复位,采用Constant- Murley肩关节评分(CMS表)、Rowe肩关节功能评分(Rowe表)、美国加州大学洛杉矶分校肩关节功能评分标准(UCLA表)、美国肩肘外科医生评估表(ASES表)和SF-36量表评估患者3个月后的量表分值,第1次评估1周后再次对患者进行4个肩关节量表评估。结果 CMS、Rowe、U-CLA

  1. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  2. Bankart Repair to Correct Shoulder Instability

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  3. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... of seeing one, assisting one and then doing one? 00:43:15 KERWYN JONES, MD: Well, that's the old adage. But, you know, in today's world a lot of techniques have been developed to ...

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  5. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... appropriate for now. Jacob asked, what's the total recovery time for this surgery? 00:36:11 KERWYN JONES, MD: Do you ... centers where we send residents and work on plastic type materials ... – and they do the surgery. And they do that multiple times. And then ...

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    Full Text Available ... patient who has undergone the surgery, and meet orthopedic surgeon Kerwyn Jones. Doctor Jones is performing the ... under one roof for in our Center for Orthopedics and Sports Medicine we can offer a comprehensive ...

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    Full Text Available ... cartilage, or labrum, to the bone and provide healing. 00:19:01 KERWYN JONES, MD: That's right. ... that were loose to self-tighten? So, can therapy…can strengthening the cuff help some of this ...

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    Full Text Available ... the patient and evaluate them with a good exam to answer correctly. 00:45:11 TODD RITZMAN, ... on our website, akronchildrens.org. And we'd encourage you to do that. And lastly, we appreciate ...

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    Full Text Available ... 02 TODD RITZMAN, MD: Yeah. I think we should continue rolling this. 00:19:05 KERWYN JONES, ... stitch follows it. That's the suture…or, I should say the suture follows it. And now we ...

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    Full Text Available ... can strengthening the cuff help some of this issue? 00:33:47 JOE CONGENI, MD: You know, ... recurrently. We're starting to look at the issues of surgery. There's a lot of consideration of ...

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    Full Text Available ... bone. During the webcast, you'll learn how doctors reattach the ligaments arthroscopically through three small incisions. ... the surgery, and meet orthopedic surgeon Kerwyn Jones. Doctor Jones is performing the leading edge arthroscopic procedure ...

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    Full Text Available ... offer a comprehensive care for athletic and sports related injuries. We have four fellowship trained pediatric primary ... 44 TODD RITZMAN, MD: So I think maybe related to the approach, Kerwyn, if you could comment ...

  3. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... MEAGAN: At first I started doing gravity assisted exercises like Codman's which are…I laid on the ... out of the fridge. That's changing their normal activities of daily living ... rehab group here and physical therapists that are really motivated to do a ...

  4. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... as they gradually get their motion back, we work early on in just getting their motion back ... devices that are little tiny cameras and they work almost like the periscope that you might have ...

  5. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... a great advance it's been since the arthroscopic age to see when we get these kids back ... 43:15 KERWYN JONES, MD: Well, that's the old adage. But, you know, in today's world a ...

  6. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... pass it through that capsule, that redundant loose looking tissue there that's been stretched out. We pass ... than a drill that you might use at home, except that it's sterile, and hopefully a little ...

  7. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... 04:42 KERWYN JONES, MD: It's a tough concept to understand, but I like your golf ball ... 00:32:28 And now here's the finished product. We're pulling on the biceps tendon. You ...

  8. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... 46:35 TODD RITZMAN, MD: Sure. That's a good point. I think when talking about new things in the frontier, also maybe could you comment ... covered, and then we'll start to wrap things ... I do believe there's a good role for rehab. Because not all those kids ...

  9. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... care. And the lastly, we can complete the cycle as we saw with Meagan, with really state ... look through something again or you have a family member or know someone who you might want ...

  10. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... again with other activities. Nonetheless, we always approach these patients first with physical therapy and rehab. So, ... even the first step is a lot of these kids in the first few days, particularly with ...

  11. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... from the bone. During the webcast, you'll learn how doctors reattach the ligaments arthroscopically through three ... lifestyle. ORlive makes it easy for you to learn more. Just click on the "Request Information" button ...

  12. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... that step. 00:18:20 KERWYN JONES, MD: Well, actually, the suture anchor has been shown to be just as strong as anchoring actually into the ... did I Page 7 of 18 mobilize it well enough to get it back into its normal ... wire, the wire will then be exchanged for the actual suture, or the stitch. ...

  13. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... that everything is magnified. So keep that in mind as you're watching the video. So go ... means that it will dissolve in the patient's body over time. Some people would use metal suture ...

  14. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... where they are in hockey checked into the board, or trying to make a tackle in football, ... do this procedure without putting the patient at risk? Is it a question of seeing one, assisting ...

  15. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... sports medicine. And Dr. Joe Congeni, who's the Director of our sports medicine center, who also has ... where they are in hockey checked into the board, or trying to make a tackle in football, ...

  16. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... screen and open the door to informed medical care. Now, let's go to the moderator of our ... and Sports Medicine we can offer a comprehensive care for athletic and sports related injuries. We have ...

  17. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... lot of these kids in the first few days, particularly with the tear, the dislocation injury, they ... lot more kids that are getting dislocations these days and what can we do about that? You ...

  18. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... surgeons. In addition, we have a full physical therapy service on site. 00:01:39 To highlight ... do you approach those two as far as treatment recommendations and your expectations for success of treatment ...

  19. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... grab a jar of…or, a bottle of mild out of the fridge. That's changing their normal ... beginning, now we're working together as a group with orthopedists, with primary care docs, helping make ...

  20. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... he came in and said, I was hit playing football and my arm in this risky position, ... one was a traumatic event that he had playing football. And, we're going to walk into ...

  1. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... a good point. I think when talking about new things in the frontier, also maybe could you ... on after the injury occurs some of the new things that are happening with immobilization after a ...

  2. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... I mean, I may be more likely to send a kid back to a sport that's non- ... right here within Akron several centers where we send residents and work on plastic type materials that ...

  3. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... RITZMAN, MD: So…but in general probably a good attitude to think that their rehab is their ... that will typically lead them to a pretty good result. JOE CONGENI, MD: Yeah. 00:39:20 ...

  4. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... 50 TODD RITZMAN, MD: So it provides our ability to anchor, or connect the soft tissues, the ... you may use at home. It has the ability for the blades to turn back and forth ...

  5. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... their prior emphasis and excitement and approach to training for a sport now to their rehab. Maybe ... years ago when we…when we were in training that the gold standard was really the open ...

  6. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... about is there's this cup with that cartilage rim around it. JOE CONGENI, MD: Um hmm 00: ... you said, is the combination of the cartilage rim as well as the capsule around the joint ...

  7. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... webcast screen and open the door to informed medical care. Now, let's go to the moderator of ... webcast screen and open the door to informed medical care. 00:51:31 [END OF WEBCAST] Page ...

  8. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... for in our Center for Orthopedics and Sports Medicine we can offer a comprehensive care for athletic ... have four fellowship trained pediatric primary care sports medicine doctors and five fellowship trained pediatric orthopedic surgeons. ...

  9. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... to that if I can, because that's a good point to talk about the fact that this surgery is not necessary for all kids. Or even ... centers where we send residents and work on plastic type materials ... – and they do the surgery. And they do that multiple times. And then ...

  10. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... to learn more. Just click on the "Request Information" button on your webcast screen and open the ... Well, really, you know, a lot of that information can be gained from the history. When you ...

  11. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... leading edge arthroscopic procedure that is designed to help a child quickly resume his or her busy ... that are watching online with us tonight, and help us to make things more relevant. So we' ...

  12. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... of that information can be gained from the history. When you talk to the patients, as Joe ... 31 TODD RITZMAN, MD: Sure. So pretty typical history of what we hear in a patient that ...

  13. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... the procedure, but this is what's called the exam under anesthesia, which tells me which direction his ... the patient and evaluate them with a good exam to answer correctly. 00:45:11 TODD RITZMAN, ...

  14. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... the surgery through the traditional, what's considered the gold standard open technique. And this means that the ... at this historically, Todd, in the past the gold standard was always to do it open. And ...

  15. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... it becomes kind of like that big basketball game you had, or softball game or, you know, football ... therapists that are really motivated to do a good job, you know, returning these kids back to sports. But ...

  16. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... has actually been through this from start to finish and had this procedure performed by Dr. Jones. ... sharing her experience through this from start to finish in a very relevant personable way that I ...

  17. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... tells me that most likely this is a kid who has that traumatic injury that you talked ... just slowly starts to develop over time, that kid needs extensive physical therapy, because most of the ...

  18. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... is the combination of the cartilage rim as well as the capsule around the joint and the ... recommendations? 00:05:11 KERWYN JONES, MD: Yeah. Well, really, you know, a lot of that information ...

  19. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... look through something again or you have a family member or know someone who you might want ... can. So, please, if things come up or family members look at Page 17 of 18 it ...

  20. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... up that same ligament or capsule. 00:09:40 TODD RITZMAN, MD: Sure. I think we'll ... very important, Todd. TODD RITZMAN, MD: Sure. 00:40:16 KERWYN JONES, MD: Yeah. And I want ...

  1. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... facing up towards the ceiling. So the patient's lying down on his right side inside the operating ... to do it open. And there's still nothing wrong with doing the surgery through an open procedure. ...

  2. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... far as treatment recommendations and your expectations for success of treatment recommendations? 00:05:11 KERWYN JONES, ... really feel that we can achieve the same success using it through the arthroscope and with less ...

  3. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... sports related injuries. We have four fellowship trained pediatric primary care sports medicine doctors and five fellowship trained pediatric orthopedic surgeons. In addition, we have a full ...

  4. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... surgeons. In addition, we have a full physical therapy service on site. 00:01:39 To highlight ... develop over time, that kid needs extensive physical therapy, because most of the kids that have that ...

  5. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... to be an athletic trainer at Mount Union College. And we have some video of her experience ... into almost any high school locker room or college locker room by the mid to late part ...

  6. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... resume his or her busy lifestyle. ORlive makes it easy for you to learn more. Just click ... tonight is performed by Dr. Kerwyn Jones and it's called an Arthroscopic Bankart Repair. I think we ...

  7. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... without it popping or anything. When I could lift like heavy boxes, or when I could lift even the coolers that we use when we fill them up with ice, I could lift that on my own without having to have ...

  8. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... he came in and said, I was hit playing football and my arm in this risky position, it ... one was a traumatic event that he had playing football. And, we're going to walk into the ...

  9. Bankart Repair to Correct Shoulder Instability

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    Full Text Available ... offer a comprehensive care for athletic and sports related injuries. We have four fellowship trained pediatric primary ... that everything is magnified. So keep that in mind as you're watching the video. So go ...

  10. Influence of Field Position on Rugby League Players Requiring Shoulder Reconstruction.

    Science.gov (United States)

    Bokor, D J; Sundaram, A; Graham, P L

    2016-06-01

    A consecutive series of patients sustaining their index anterior instability while playing Rugby League and requiring shoulder reconstruction was retrospectively reviewed and evaluated. The details of their on-field position and hand dominance at time of injury, the side of injury, and mechanism of injury were collated and statistically analyzed. A total of 173 Bankart repairs were performed on 132 patients, and 102 players had one injury while 30 had 2 or more injuries. Players are more likely to injure their non-dominant side (P=0.009) in the first-time injury. Whereas second and subsequent injuries were not associated with a particular side (P=0.81). Applying a Bonferroni correction to the chi-squared goodness-of-fit test of position at time of injury revealed players on the wing had a significantly lower frequency of injury (Pdislocations with the lock and fullback positions incurring significantly more re-injuries and the wing position fewer re-injuries than expected (P<0.006). Understanding which player positions on the rugby league field are more likely to sustain an anterior instability will assist medical and support staff to optimize the pre-season conditioning and post surgical rehabilitation of players. PMID:26990719

  11. Joint instability and osteoarthritis.

    Science.gov (United States)

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  12. US of the shoulder

    International Nuclear Information System (INIS)

    Twenty five healty people and 25 patients with shoulder pain underwent US control over a 12-month period: 24 patients with shoulder pain had rotator cuff and/or biceps tendon lesions. The US findings on rotator cuff and biceps tendon lesions are compared with those of arthrography and/or surgery (96% sensitivity). US is rapid, safe, non invasive, inexpensive and often more accurate, and its use is recommended for the routine examination of the shoulder joint insteat of arthrography

  13. Glenoid Dysplasia in the Recurrent Shoulder Dislocation: A Case Report

    Directory of Open Access Journals (Sweden)

    Hamza Sucuoglu

    2016-02-01

    Full Text Available Glenoid dysplasia, which is often ignored, is a rare developmental anomaly. In most cases the patients remain asymptomatic. Although glenoid dysplasia has been diagnosed by incidentally on chest radiograph, also it has been described because of the developing instability of shoulder joint. Our young male patient who has recurrent dislocation of the shoulder-joint 4-5 times a year for last 5 years, dislocation has been reduced in the emergency department and he has been discharged from hospital with shoulder strap and rest. Finally when he admitted to our outpatient clinic with recurrent shoulder dislocation, the diagnosis of glenoid dysplasia is revealed by X-ray examination. We present the diagnose of glenoid dysplasia with clinical and radiological findings which should be kept in mind in patients with recurrent dislocations of shoulder as in our case.

  14. Magnetic resonance imaging of the shoulder: Rationale and current applications

    International Nuclear Information System (INIS)

    Because it can demonstrate a wide range of tissue contrast with excellent resolution, magnetic resonance (MR) imaging has revolutionized imaging in many areas of the musculoskeletal system and has generated excitement among those interested in the painful shoulder. Shoulder impingement syndrome and glenohumeral instability constitute the two major categories of shoulder derangements. Correct diagnosis requires the use of appropriate pulse sequences and imaging planes, proper patient positioning, and a satisfactory surface coil. In addition the imager must have a thorough understanding of shoulder anatomy and pathology. We present a summary of the current status of MR imaging of the shoulder including technical, anatomic, and pathologic considerations and a review of the pertinent literature. (orig.)

  15. Glenoid Dysplasia in the Recurrent Shoulder Dislocation: A Case Report

    OpenAIRE

    Hamza Sucuoglu

    2016-01-01

    Glenoid dysplasia, which is often ignored, is a rare developmental anomaly. In most cases the patients remain asymptomatic. Although glenoid dysplasia has been diagnosed by incidentally on chest radiograph, also it has been described because of the developing instability of shoulder joint. Our young male patient who has recurrent dislocation of the shoulder-joint 4-5 times a year for last 5 years, dislocation has been reduced in the emergency department and he has been discharged from hospita...

  16. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    OpenAIRE

    Patro Dilip K; Agarwal Dinesh K; Saseendar S; Menon Jagdish

    2009-01-01

    Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in Engl...

  17. Ipsilateral fracture dislocation of the shoulder and elbow: A case report and literature review

    OpenAIRE

    Behr, Ian; Blint, Andy; Trenhaile, Scott

    2013-01-01

    Ipsilateral dislocation of the shoulder and elbow is an uncommon injury. A literature review identified nine previously described cases. We are reporting a unique case of ipsilateral posterior shoulder dislocation and anterior elbow dislocation along with concomitant intra-articular fractures of both joints. This is the first report describing this combination of injuries. Successful treatment generally occurs with closed reduction of ipsilateral shoulder and elbow dislocations, usually reduc...

  18. Using your shoulder after surgery

    Science.gov (United States)

    ... Rotator cuff problems Rotator cuff repair Shoulder arthroscopy Shoulder pain Patient Instructions Rotator cuff exercises Rotator cuff - self-care Shoulder surgery - discharge Update Date 11/26/2014 Updated ...

  19. Protocol for Shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mortensen Ole S

    2011-01-01

    Full Text Available Abstract Background Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions treated by physical therapists. The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments. Active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area. Our study investigates the effect of the latter approach. Methods/Design A randomized controlled trial of 10 weeks duration is currently being conducted. Employed office workers with severe neck-shoulder pain are randomized to 3 × 20 min shoulder function training with training supervision or to a reference group receiving advice to stay physically active. Shoulder function training primarily focuses on the serratus anterior and lower trapezius muscle with only minimal activation the upper trapezius. An announcement was sent to the administrative section of the university including jobs characterized by intensive computer work. The first 100 positive replies entered the study. Among these inclusion criteria were pain intensity in the neck/shoulder of at least 3 on a 0-9 scale. Exclusion criteria were cardiovascular disease, trauma, hypertension, or serious chronic disease. Before and after the intervention period the participants replied to a questionnaire about musculoskeletal disorders and work disability, and underwent a standardized clinical examination of the neck and shoulder girdle. Further, on a weekly basis the participants log pain intensity of the neck and shoulder during the previous week. The primary outcome measure is pain in the neck and shoulders at week 10 based on the weekly pain registration and results

  20. Spectrum of shoulder injuries in the baseball pitcher

    International Nuclear Information System (INIS)

    This review describes a range of shoulder injuries experienced by baseball pitchers. It is estimated that more than 57% of pitchers suffer some form of shoulder injury during a playing season. Knowledge of the overhead throwing cycle is crucial for our understanding of these shoulder injuries. Baseball pitchers are prone to rotator cuff tears from tensile overload and impingement. Glenoid labrum degeneration or tears are also common, due to overuse syndrome (micro-instability), internal impingement and microtrauma. An understanding of the lesions involved in overhead throwing is crucial in baseball pitchers, as long-term disability can result from these injuries, sometimes with severe financial consequences to the player. (orig.)

  1. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... Anatomic Total Shoulder surgery, which featured the latest innovation in shoulder surgery from DePuy Orthopedics. OR-Live makes it easy for you to learn more. Just click on the "Request Information" button on your webcast screen and open the door to informed medical care. 01:21: ...

  2. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... advancing the standard of orthopedic patient care. In a few moments, you'll be able to watch a live global AP anatomic total shoulder surgery from Methodist Hospital in Philadelphia. A revolution in shoulder orthopedics, the Global AP gives ...

  3. İki taraflı anterior omuz çıkığı: Olgu sunumu ve literatür taraması

    OpenAIRE

    Ozan, F; Altay, T; Koyuncu, Ş; Çeliker, H

    2014-01-01

    Dislocation is more often encountered due to multilateral mobility of the shoulder joint, its anatomic characteristics, and its being more exposed to traumas. Shoulder dislocations are often anterior and unilateral; though rare, bilateral shoulder dislocations are also encountered. Such dislocations are mostly posterior. A simultaneous bilateral anterior shoulder dislocation is extremely rare. In the current study, we present the case of a 55-year-old female patient, with a simultaneous bilat...

  4. Arthroplasty versus arthroscopy for recurrent anterior dislocation of the shoulder joint with severe bone defects:3-year follow-up%关节置换与关节镜下修复肩关节复发性前脱位伴重度骨缺损:3年随访对比

    Institute of Scientific and Technical Information of China (English)

    陈辉; 王群; 燕双喜; 董天云; 邹海兵

    2015-01-01

    背景:随着外科技术、重建材料技术的发展,关节置换在肩关节脱位中也得到了广泛应用,特别是各种定制型或装配型假体使得置换适应证明显提高。  目的:观察与随访关节镜与关节置换治疗肩关节复发性前脱位伴重度骨缺损的远期疗效。  方法:纳入肩关节复发性前脱位伴重度骨缺损患者144例,根据随机抽签分为治疗组与对照组,每组72例。对照组行关节镜下内固定治疗,治疗组行关节置换治疗。通过电话调查与复诊完成3年随访,记录患者Neer肩关节功能评分、肩关节活动度及并发症发生情况。  结果与结论:随访3年,治疗组的肩关节功能优良率90%明显高于对照组81%(P RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

  5. Instability of the hindfoot after lesion of the lateral ankle ligaments: investigations of the anterior drawer and adduction maneuvers in autopsy specimens

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Madsen, F.;

    1991-01-01

    The mobility patterns in the tibiotalocalcaneal joint complex with a solitary lesion of the anterior talofibular ligament (ATL) and a combined lesion of the ATL and calcaneofibular ligament (CFL) were studied in 22 human lower-extremity autopsy specimens mounted in a kinesiologic testing device. A...... solitary lesion of the ATL increased the anteroposterior (AP) laxity in the ankle joint in the entire range of flexion, with a maximum median of 3.1 mm in neutral flexion. Further cutting of the CFL increased AP laxity most obviously in dorsiflexion. A solitary lesion of the ATL resulted in a minor...

  6. MR and MR arthrography to identify degenerative and posttraumatic diseases in the shoulder joint

    International Nuclear Information System (INIS)

    MR imaging provides a comprehensive evaluation of a wide spectrum of both intraarticular and extraarticular pathology of the shoulder. MR imaging enables the detection or exclusion of degenerative and posttraumatic diseases of the shoulder with a reasonable accuracy. MR arthrography is useful in the visualization of subtle anatomic details and further improves the differentiation. In this article, findings of MR imaging and MR arthrography of degenerative and posttraumatic shoulder diseases (impingement syndrome, rotator cuff tears, and glenohumeral instability) has been reviewed

  7. Myositis ossificans around shoulder following military training programme

    Directory of Open Access Journals (Sweden)

    Mustafa C Kir

    2011-01-01

    Full Text Available The myositis ossificans around shoulder in military recruits are not reported yet. Three young male soldiers presented with complaints of palpable mass at the anterior aspect of shoulder; tenderness around the superior part of deltopectoral groove close to acromioclavicular joint; and restriction of shoulder motion. They also noticed ecchymosis and pain around the coracoid process and anterior shoulder region during regular firing exercises. Plain X-rays and computerized tomography showed extra-capsular, dense, irregular structure in the space between pectoralis and deltoid muscles which correlated with heterotopic bone. One patient refused surgical intervention because of the completion of his military serving period. Surgical excision was performed for the other two patients. During surgical exploration, both ossified masses were found in deltopectoral region and mostly in fibers of clavicular and acromial parts of deltoid muscle. Pathological reports confirmed the structure of masses as mature trabecular bone. Postoperatively indomethacin treatment and active shoulder exercises were started until the full range of motion was regained. Mini soft bag was used on the rifle contact area of the shoulder. No complications or recurrences were observed during the 24 months of followup period.

  8. Diagnostic imaging of shoulder impingement

    International Nuclear Information System (INIS)

    Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage

  9. Ankle and shoulder joint reconstruction using soft tissue allografts

    International Nuclear Information System (INIS)

    Full text: Lateral Collateral Ligament Insufficiency is a common complication of injury to the ankle joint. This needs reconstruction of the torn ligament as the joint instability gives rise to frequent giving way at the ankle joint. It can be reconstructed using autologous peroneus brevis tendon. The authors prefer to reconstruct using deep frozen (-80 degree C) non-gamma irradiated tibialis anterior or tibialis posterior tendon allograft procured by NUH Tissue Bank. The graft must be at least between 18-22 cm long. The procedure employed is a first stage Brostrom Procedure repairing the anterior talo-fibula ligament using Mitek sutures. In the second stage the Calcaneofibular ligament is reconstructed using a figure of eight tendon reconstruction via drill holes in the fibular above and the calcaneum below. Twelve cases have been reconstructed this way with good results. When injury is sustained to the Acromia-clavicular (AC) Joint, for type 3 to 5 AC Joint Dislocation and in manual labourers, reconstruction is needed. The author's preferred method is a 2 stage procedure using deep frozen (-80 degree C), non gamma-irradiated fascia lata allografts procured by NUH Tissue Bank. In the first stage the dislocated AC Joint is reduced and held in position by transfixation using 2 baby Steinmann Pins and repair of torn corac clavicular ligaments. The second stage consisted of reconstruction with rolled-up fascia lata figure of eight allograft tendon between the clavicle and the coracoid process. The 2 pins are removed after 6 weeks and the shoulder mobilised. 10 cases have been done with good results. Two cases showed mild subluxation of the AC joint due to slight loss of the reduction performed during the operation. (Author)

  10. The Shoulder Gradient in Patients with Unilateral Shoulder Impingement Syndrome

    OpenAIRE

    Kim, Hee-Sang; Lee, Jong Ha; Yun, Dong Hwan; Yun, Jee-Sang; Shin, Yong Won; Chon, Jinmann; Hwang, Dae Gyu

    2011-01-01

    Objective To investigate the relationship between the shoulder gradient and acromiohumeral interval of both shoulders in patients with unilateral shoulder impingement syndrome. Method Using the angulometer, we measured the shoulder gradient in patients with unilateral shoulder impingement syndrome in a standing position. Using the radiography, we measured the acromiohumeral interval and the angle between a vertical line and a line connecting a superior angle with an inferior angle of the scap...

  11. Detailed Shoulder MRI Findings in Manual Wheelchair Users with Shoulder Pain

    Directory of Open Access Journals (Sweden)

    Melissa M. B. Morrow

    2014-01-01

    Full Text Available Shoulder pain and pathology are common in manual wheelchair (MWC users with paraplegia, and the biomechanical mechanism of injury is largely unknown. Establishing patterns of MRI characteristics in MWC users would help advance understanding of the mechanical etiology of rotator cuff disease, thus improving the logic for prescribed interventions. The purpose of this study was to report detailed shoulder MRI findings in a sample of 10 MWC users with anterolateral shoulder pain. The imaging assessments were performed using our standardized MRI Assessment of the Shoulder (MAS guide. The tendon most commonly torn was the supraspinatus at the insertion site in the anterior portion in either the intrasubstance or articular region. Additionally, widespread tendinopathy, CA ligament thickening, subacromial bursitis, labral tears, and AC joint degenerative arthrosis and edema were common. Further reporting of detailed shoulder imaging findings is needed to confirm patterns of tears in MWC users regarding probable tendon tear zone, region, and portion. This investigation was a small sample observational study and did not yield data that can define patterns of pathology. However, synthesis of detailed findings from multiple studies could define patterns of pathological MRI findings allowing for associations of imaging findings to risk factors including specific activities.

  12. Operative treatment of medial rotation contracture of the shoulder caused by obstetric brachial plexus palsy

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To introduce an operation of subscapularis slide from its origin and anterior release from its insertion for treatment of medial rotation contracture, subluxation and dislocation of the shoulder caused by obstetric brachial plexus palsy (OBPP). Methods: Thirty-six cases with medial rotation contracture of the shoulder were diagnosed by measurement of the inferior glenohumeral angle, passive lateral rotation of the shoulder and plain radiographs. Subscapularis slide was performed in 24 cases with simple medial rotation contracture, and anterior release in 12 cases with complex contracture-medial rotation contracture combined with subluxation, dislocation, or other deformities of the shoulder joint. Systems of Mallet scoring and Gilbert grading for the shoulder were used to evaluate the postoperative shoulder function. Results: With follow up for a minimum of six months, 32 cases got apparent gains from operations,accounting for 88.8% of the total operated on. The younger the child was, the better the result. Of 4 cases with no operative effects, 3 had no flexion of the elbow preoperatively, suggesting a poor recovery of the upper trunk of the brachial plexus; the rest one had no repair of the severed subscapularis tendon. Conclusions: Subscapularis slide and anterior release of the shoulder are effective for treatment of medial rotation contracture as well as its consequence of subluxation and dislocation of the shoulder in OBPP. The operative effect is related to children's age and the recovery extent of the upper trunk of the brachial plexus.

  13. MRI of the posttraumatic shoulder

    International Nuclear Information System (INIS)

    Full text: Abnormalities of the shoulder are common but still unclear for both GPs and the orthopedic surgeon in our community. Difficult and late these patients are directed to a specialist for diagnosis and treatment. Our goal is to address some of the key and most common problem conditions related to the complaints in this area. Incidence of symptomatic ruptures of the shoulder’s rotator cuff is difficult to be evaluated. But it is by no means rare, concerning the research in the world - historically and today. It is also known that ruptures can be asymptomatic. Despite the large percentage of them, many of them are at risk for progression of the symptoms. While, on the world, the authors explicitly state that dealing with a rotator cuff rupture is one of the top 10 issues that are most important for orthopedic surgeons, in our country the most common diagnosis for shoulder complaints is still periarthritis, without specifying of individual muscles pathology. Another major concern is shoulder instability associated with multiple incidents of luxation started either in adolescence with minor traumatic incident, such as recurrent dislocation, or started after severe trauma in older ages. It has to be specified diagnostic type of instability: front, rear or multidirection. Especially it is important to make the initial stabilization period of unavoidable long series of repeated dislocations in adolescents and young people, whether actively practicing sports or not. This point is often missed, and later for large lesions it leads to more invasive surgery. Not infrequently this condition is characterized by pain and limited movement without true dislocation. Then it is mandatory to assess the diagnostic changes in labrum, ligaments and muscles, not to leave the patient to reach first dislocation. Impingement syndrome (IC) is a common suffering, engaging soft tissues in the subacromial bursitis. IC characterizes by pain during the upper limb removal and the

  14. Reverse Shoulder Arthroplasty

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    Full Text Available ... March 17, 2010 Welcome to this OR Live presentation, brought to you by Zimmer. Hi. I'm ... learn about shoulder replacement. You can do a skills course at the learning center that the academy ...

  15. Anatomic Total Shoulder System

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    Full Text Available ... with regard to longevity of total shoulders versus hips and knees. 00:46:20 GERALD WILLIAMS, MD: ... is almost ten years younger than the average hip or knee replacement patient. But if you look ...

  16. Anatomic Total Shoulder System

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    Full Text Available ... N. DOUGLAS BOARDMAN III, MD: That's an occupational hazard of shoulder surgery. 00:50:53 GERALD WILLIAMS, MD: That's an occupational hazard. I'm going to become disabled at some ...

  17. Reverse Shoulder Arthroplasty

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    Full Text Available ... replacement. There are two basic approaches you can use for reverse shoulder replacement. The standard delto-pectoral ... surgery or a deltoid defect because you can use the same incision and repair any deltoid defects ...

  18. Anatomic Total Shoulder System

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    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient care. In a few ...

  19. Anatomic Total Shoulder System

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    Full Text Available ... MD: This is Doug Boardman from Richmond, Virginia. We're here at Methodist Hospital in Philadelphia, where ... will be performing a total shoulder arthroplasty. Before we go to Dr. Williams, I'd like to ...

  20. Reverse Shoulder Arthroplasty

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    Full Text Available ... with an intact cuff, we would consider a traditional shoulder replacement. There are two basic approaches you ... less limited with the superior reverse versus the traditional. And I assume the question means the approach: ...

  1. Reverse Shoulder Arthroplasty

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    Full Text Available ... reverse shoulder arthroplasty for cuff deficient arthritis. You should be aware that I helped design the system ... the delto- pectoral approach. The three features you should watch for in this video are the things ...

  2. Anatomic Total Shoulder System

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    Full Text Available ... do to give yourself a big break as far as glenoid exposure is concerned is to narrow ... for joint replacement in the United States by far, by almost ten years, is shoulders. So by ...

  3. Reverse Shoulder Arthroplasty

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    Full Text Available ... is tight, in terms of tension? What's your thinking on that? Well, when we originally started doing ... learn about shoulder replacement. You can do a skills course at the learning center that the academy ...

  4. Anatomic Total Shoulder System

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    Full Text Available ... patient is a 78-year-old male who has osteoarthritis of his left shoulder. If you look ... does not have a really big inferior osteophyte. Has a little bit of proximal migration and even ...

  5. Anatomic Total Shoulder System

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    Full Text Available ... We had a question with regard to physical therapy after total shoulder arthroplasty: expectations and limitations. 00: ... opposite. We don't -- we do hardly any therapy at all to reverse. With reverse patients, they ...

  6. Anatomic Total Shoulder System

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    Full Text Available ... to a patient's unique anatomical makeup. Dr. Gerald R. Williams, Jr., a shoulder specialist from the Rothman ... That might help. Could you raise the O.R. table, please? 00:28:35 WOMAN: Can you ...

  7. Anatomic Total Shoulder System

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    Full Text Available ... 52 N. DOUGLAS BOARDMAN III, MD: That's an occupational hazard of shoulder surgery. 00:50:53 GERALD WILLIAMS, MD: That's an occupational hazard. I'm going to become disabled at ...

  8. Anatomic Total Shoulder System

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    Full Text Available ... shoulder arthroplasty. Before we go to Dr. Williams, I'd like to encourage viewers to feel free ... utilizing the buttons on your screen. And now I'll turn it over to Dr. Williams. 00: ...

  9. Reverse Shoulder Arthroplasty

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    Full Text Available ... you can use for reverse shoulder replacement. The standard delto-pectoral approach, or the superior approach, which ... that are different between a reverse and a standard total is, first of all, we don't ...

  10. Anatomic Total Shoulder System

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    Full Text Available ... Korea. This patient is a 78-year-old male who has osteoarthritis of his left shoulder. If ... you another example: 40-year-old really muscular male weight lifter. That person's going to go back ...

  11. Anatomic Total Shoulder System

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    Full Text Available ... Pennsylvania, will perform the procedure, as shoulder and elbow reconstruction specialist, Dr. Douglas Boardman III will moderate. ... two weeks and don't do anything except elbow, wrist, and hand activities. At around two weeks, ...

  12. Anatomic Total Shoulder System

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    Full Text Available ... be performing a total shoulder arthroplasty. Before we go to Dr. Williams, I'd like to encourage ... It's always a question about how deep we go with this osteotomy. I tend to go almost ...

  13. Anatomic Total Shoulder System

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    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient ...

  14. Anatomic Total Shoulder System

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    Full Text Available ... WILLIAMS, MD: The patients that have a total shoulder replacement will come in on their first postoperative visit and tell you their pain's gone. The hemi arthroplasty without interposition will come ...

  15. Reverse Shoulder Arthroplasty

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    Full Text Available ... option in the last decade for cuff deficient shoulder arthritis in the United States. The indications are a patient with painful arthritis, absent rotator cuff, a less demanding occupation ...

  16. Anatomic Total Shoulder System

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    Full Text Available ... to longevity of total shoulders versus hips and knees. 00:46:20 GERALD WILLIAMS, MD: Well, obviously, ... ten years younger than the average hip or knee replacement patient. But if you look at the ...

  17. Shoulder Joint Replacement

    Science.gov (United States)

    ... en because of implant loosening, wear, infection, and dislocation. When this occurs, a second joint replacement surgery — called a revision surgery — may be necessary. Is Shoulder Joint Replacement for You? The decision to have ...

  18. Reverse Shoulder Arthroplasty

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    Full Text Available ... here in New York to bring you a video of a recent case of reverse shoulder arthroplasty ... helped design the system that's shown in this video, so I receive royalties and therefore have a ...

  19. Reverse Shoulder Arthroplasty

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    Full Text Available ... residents and do receive compensation for that, as well. Now, reverse shoulder arthroplasty is a new option ... t see the neck of the humerus as well, but on the other hand, you have a ...

  20. Normal shoulder: MR imaging

    International Nuclear Information System (INIS)

    Relatively poor spatial resolution has been obtained in magnetic resonance (MR) imaging of the shoulder because the shoulder can only be placed in the periphery of the magnetic field. The authors have devised an anatomically shaped surface coil that enables MR to demonstrate normal shoulder anatomy in different planes with high spatial resolution. In the axial plane anatomy analogous to that seen on computed tomographic (CT) scans can be demonstrated. Variations in scapular position (produced by patient positioning) may make reproducibility of sagittal and coronal plane images difficult by changing the relationship of the plane to the shoulder anatomy. Oblique planes, for which the angle is chosen from the axial image, have the advantage of easy reproducibility. Obliquely oriented structures and relationships are best seen in oblique plane images and can be evaluated in detail

  1. Radiotherapy for shoulder impingement

    International Nuclear Information System (INIS)

    Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term ''periarthritis humeroscapularis''. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

  2. Cine-MR imaging of the shoulder

    International Nuclear Information System (INIS)

    Purpose: Shoulder lesions are usually examined with the joint in only one or two positions. We examined the shoulder with the joint in a variety of positions. We also assessed the application of cine-MR to the detection of instability and impingement. Material and Methods: The cine-MR examinations were performed in 30 patients and 15 healthy volunteers. We used an open 0.2 T system and a closed 1.0 T system. Spoiled gradient echo 2D T1-weighted images and turbo spin-echo T1- and T2-weighted images were obtained with a field of view of 180 mm. The examinations were videotaped and evaluated later. Results: Normal variations of the glenohumeral joint were easy to recognize. Subluxations and luxations of the humeral head as well as rupture of the labrum were identified. It was also possible to identify the labrum with a signal change after arthroscopic refixation. And we were able to objectively assess distances between the osseous structures during dynamic movement. Conclusion: Unlike static MR, cine-MR would appear to be useful in visualizing the capsular ligament complex of the gleno-humeral joint in impingement and instability. It also provides information on dynamic changes and may thus prove to be an important tool for shoulder diagnostics. The method may provide an early diagnosis in the subacromial impingement syndrome. (orig.)

  3. Efficacy of labral repair, biceps tenodesis, and diagnostic arthroscopy for SLAP Lesions of the shoulder: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Mowinckel Petter

    2010-10-01

    Full Text Available Abstract Background Surgery for type II SLAP (superior labral anterior posterior lesions of the shoulder is a promising but unproven treatment. The procedures include labral repair or biceps tenodesis. Retrospective cohort studies have suggested that the benefits of tenodesis include pain relief and improved function, and higher patient satisfaction, which was reported in a prospective non-randomised study. There have been no completed randomised controlled trials of surgery for type II SLAP lesions. The aims of this participant and observer blinded randomised placebo-controlled trial are to compare the short-term (6 months and long-term (2 years efficacy of labral repair, biceps tenodesis, and placebo (diagnostic arthroscopy for alleviating pain and improving function for type II SLAP lesions. Methods/Design A double-blind randomised controlled trial are performed using 120 patients, aged 18 to 60 years, with a history for type II SLAP lesions and clinical signs suggesting type II SLAP lesion, which were documented by MR arthrography and arthroscopy. Exclusion criteria include patients who have previously undergone operations for SLAP lesions or recurrent shoulder dislocations, and ruptures of the rotator cuff or biceps tendon. Outcomes will be assessed at baseline, three, six, 12, and 24 months. Primary outcome measures will be the clinical Rowe Score (1988-version and the Western Ontario Instability Index (WOSI at six and 24 months. Secondary outcome measures will include the Shoulder Instability Questionnaire (SIQ, the generic EuroQol (EQ-5 D and EQ-VAS, return to work and previous sports activity, complications, and the number of reoperations. Discussion The results of this trial will be of international importance and the results will be translatable into clinical practice. Trial Registration [ClinicalTrials.gov NCT00586742

  4. Reverse Shoulder Arthroplasty

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    Full Text Available ... use a vertical incision along the anterior lateral edge of the acromium. This approach tends to be ... that your incision goes onto the anterior lateral edge of the acromium, rather than reflecting the deltoid ...

  5. The Painful Shoulder: Shoulder Impingement Syndrome

    OpenAIRE

    Khan, Yousaf; Nagy, Mathias Thomas; Malal, Joby; Waseem, Mohammad

    2013-01-01

    Rotator cuff disorders are considered to be among the most common causes of shoulder pain and disability encountered in both primary and secondary care. The general pathology of subacromial impingment generally relates to a chronic repetitive process in which the conjoint tendon of the rotator cuff undergoes repetitive compression and micro trauma as it passes under the coracoacromial arch. However acute traumatic injuries may also lead to this condition. Diagnosis remains a clinical one, how...

  6. Magnetic resonance imaging of the shoulder: a review of potential sources of diagnostic errors

    International Nuclear Information System (INIS)

    Shoulder magnetic resonance (MR) imaging and MR arthrography are frequently utilized in the evaluation of shoulder pain and instability. The clinical scenario and imaging findings may be confusing to clinicians and radiologists and may present diagnostic challenges for those involved in evaluating and treating shoulder pathology. Often rotator cuff and labral abnormalities may be coexistent, clinical manifestations of denervation syndromes may be confusing to clinicians, and normal anatomic variations, imaging pitfalls, and various artifacts may cause dilemmas for the radiologist. This article will review the most frequently encountered mimickers and pitfalls of MR imaging of the shoulder. (orig.)

  7. Multidetector spiral CT arthrography of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Lecouvet, Frederic E. [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)], E-mail: frederic.lecouvet@uclouvain.be; Simoni, Paolo; Koutaissoff, Sophie; Vande Berg, Bruno C.; Malghem, Jacques; Dubuc, Jean-Emile [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)

    2008-10-15

    Although MR imaging and MR arthrography are the first choice modalities for shoulder imaging, CT arthrography (CTA) may be used successfully to address many clinical questions. The advent of submillimeter multiple detector CT technology and subsequent excellent three-plane resolution has considerably increased the quality of CTA examinations and has propelled this technique to the forefront in a growing number of indications. The combined use of iodinated contrast material for fluoroscopic confirmation of the articular position of the needle before injection of gadolinium chelates for MR arthrography offers the unique opportunity to compare CTA and MRA findings in carefully selected cases. This paper illustrates capabilities and limits of CTA for the study of rotator cuff tears, shoulder instability, cartilage lesions, anatomical variants and abnormalities of the glenoid labrum, with correlations to MR arthrography and surgical findings.

  8. Multidetector spiral CT arthrography of the shoulder

    International Nuclear Information System (INIS)

    Although MR imaging and MR arthrography are the first choice modalities for shoulder imaging, CT arthrography (CTA) may be used successfully to address many clinical questions. The advent of submillimeter multiple detector CT technology and subsequent excellent three-plane resolution has considerably increased the quality of CTA examinations and has propelled this technique to the forefront in a growing number of indications. The combined use of iodinated contrast material for fluoroscopic confirmation of the articular position of the needle before injection of gadolinium chelates for MR arthrography offers the unique opportunity to compare CTA and MRA findings in carefully selected cases. This paper illustrates capabilities and limits of CTA for the study of rotator cuff tears, shoulder instability, cartilage lesions, anatomical variants and abnormalities of the glenoid labrum, with correlations to MR arthrography and surgical findings

  9. Radiological Projection for Diagnosis of Shoulder Subluxation in Patients with Post-Stroke Hemiplegia

    International Nuclear Information System (INIS)

    The purpose of this study was to find out useful radiological projection of shoulder subluxation in patients with post-stroke hemiplegia. A total of 33 patients with post-stroke hemiplegia were included(20 men and 13 women, mean age 62.3 years) and having the subluxed shoulder over one finger breath. The shoulder subluxation was determined as the ratio of the radiographic vertical and horizontal distance. The vertical distance was determined by measuring the distance between the most inferolateral point of the acromion and the central point of the humeral head. The horizontal distance was determined by measuring the distance between the central point of the glenoid fossa and the central point of the humeral head. To measure of the shoulder subluxation, the shoulder AP, axial and transthoracic lateral projections were taken on both affected and unaffected shoulders. We analyzed the difference of subluxation distance by t-test. When patients was in sitting position, the average time of being shoulder subluxation was 123 second. There was significant difference between supine(49.90±13.6 mm) and sitting position(60.72±16.3 mm) in the vertical distance of shoulder anterior-posterior projection. Also, there was significant difference on transthoracic lateral projections, Affected 35.92±6.2 mm, Unaffected 28.76±5.4 mm. But in case of shoulder axial projection(supine position), there was no significant difference (Unaffected and affected was 23.01±9.0 mm, 22.45±8.2 mm each). Radiological projection of shoulder subluxation has diagnostic value when it goes after check out the process of subluxation through finger breadth test. For this, patients must be in sitting and shoulder neutral position about 2 minutes. In addition, Shoulder anterior-posterior and transthoracic projection were significant to diagnose subluxation. But in axial projection, there wasn't meaningful differences.

  10. Using your shoulder after replacement surgery

    Science.gov (United States)

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made ...

  11. Shoulder impingement syndrome in relation to shoulder intensive work

    OpenAIRE

    Frost, P.; Andersen, J H

    1999-01-01

    OBJECTIVES: To analyse the risk of shoulder impingement syndrome relative to shoulder intensive work. METHODS: A cross sectional study of a historical cohort of 1591 workers employed between 1986 and 1993 at a slaughterhouse or a chemical factory. Workers not doing tasks in slaughtering or meat processing constituted the reference group. Intensity of shoulder work in meat processing tasks was assessed by video based observations. Information on shoulder disorders was collected by quest...

  12. Direct MR-arthrography of the shoulder with maximum capsular distension for surgical planning

    International Nuclear Information System (INIS)

    Purpose: To evaluate the effectiveness of direct MR arthrography of the glenohumeral joint with maximum distension of the joint capsule in patients with glenohumeral instability for preoperative diagnosis and for determining the method of surgical intervention. Materials and Methods: MR arthrography of the shoulder joint was performed on a 1.5 T system in 38 patients. All patients suffered from anterior or bidirectional instability. Using a fluoroscopically guided posterior approach, a 1% dilution of dimeglumine gadopentetate (5 mmol Gd-DTPA/l) was injected until full capsular stretching was achieved. MR imaging protocol included fat-saturated transversal, oblique-coronal and oblique-sagittal T1-weighted spin-echo, T1-weighted 3-D and transversal T2-weighted Flash-2D. Results: MR imaging revealed significant capsule distention in 22 patients and ventral capsule defects in 9 patients. Labral lesions were depicted in 25 patients, bicipital tendon lesions in 4 patients and partial ruptures of the rotator cuff in 3 patients. 15 of the 38 patients underwent surgery. Areas of pathologic laxity of the glenohumeral capsule were correctly described in all cases. In 12 of 15 patients, the best method of intervention could be determined prospectively. In 3 of 15 patients, the necessary operation was overestimated. Regarding labral ruptures, MRI had a sensitivity of 88%, a specificity of 86%, and a diagnostic accuracy of 87%. (orig.)

  13. The Danish Shoulder Arthroplasty Registry

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe; Jakobsen, John; Brorson, Stig;

    2012-01-01

    The Danish Shoulder Arthroplasty Registry (DSR) was established in 2004. Data are reported electronically by the surgeons. Patient-reported outcome is collected 10-14 months postoperatively using the Western Ontario osteoarthritis of the shoulder index (WOOS). 2,137 primary shoulder arthroplasties...

  14. Effects of interscalene brachial plexus block to intra-operative hemodynamics and postoperative pain for arthroscopic shoulder surgery

    OpenAIRE

    Lee, Hyun-Young; Kim, Sang Hun; So, Keum Yung; Kim, Dong Jun

    2012-01-01

    Background Although arthroscopic shoulder surgery is less invasive and painful than open shoulder surgery, it can often cause intra-operative hemodynamic instability and severe post-operative pain. This study was conducted to investigate the efficacy of the interscalene brachial plexus block (IBPB) on intra-operative hemodynamic changes and post-operative pain during arthroscopic shoulder surgery. Methods After institutional review board approval, 50 consecutive patients that had undergone ar...

  15. COMPARING EFFECT OF SHOULDER CUFF SUPPORT VERSUS SHOULDER STRAPPING IN PREVENTING POST STROKE SHOULDER PAIN

    OpenAIRE

    Parvinder kaur; Shiv Kumar Verma; Ravinder Narwal

    2013-01-01

    Aims and Objectives:The aim of research is to compare the effectiveness of shoulder cuff support versusshoulder strapping.Methodology:A sample of 20 strokesubjects was recruited for the study. The subjectwere randomly dividedin to 2 groups Group A ( shoulder cuff group) and Group B (shoulder strapping group).Pre test assessment was done by Visual analogue scale & pain free range of motion to 900degree. A receivedshoulder cuff and group B received shoulder strapping in their rehabilitation pro...

  16. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy ... you don't make a bunch of small passes at the lesser tuberosity and make it a ...

  17. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... April 17, 2008 00:00:10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient care. In a few moments, you'll ... Methodist Hospital in Philadelphia. A revolution in shoulder orthopedics, the Global AP gives surgeons a wide array ...

  18. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... to longevity of total shoulders versus hips and knees. 00:46:20 GERALD WILLIAMS, MD: Well, obviously, if you look at -- it depends upon who you put them in. First of all, the young-- the youngest patient population for joint replacement in the United States by far, by ...

  19. Anatomic Total Shoulder System

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    Full Text Available ... from South Korea. This patient is a 78-year-old male who has osteoarthritis of his left shoulder. If ... some pain relief. Give you another example: 40-year-old really muscular male weight lifter. That person's going to go back ...

  20. Exercise and Shoulder Pain

    Science.gov (United States)

    ... and disability • Fractures: A break in a bone • Dislocations/subluxations: Complete or partial separation of bones within the joint • Sprains: Stretch/damage to ligaments and connective tissue within the joint • Frozen Shoulder: Stiffness & loss of movement; a tight connective joint ...

  1. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... Erika, she must've left. She got scared. Kevin from DePuy. And we have Dr. Song visiting us from South Korea. This patient is a 78-year-old male who has osteoarthritis of his left shoulder. If you look at his AP view here, what we can see is that he doesn't have quite the ...

  2. Mortality after shoulder arthroplasty

    DEFF Research Database (Denmark)

    Amundsen, Alexander; Rasmussen, Jeppe Vejlgaard; Olsen, Bo Sanderhoff;

    2016-01-01

    BACKGROUND: The primary aim was to quantify the 30-day, 90-day, and 1-year mortality rates after primary shoulder replacement. The secondary aims were to assess the association between mortality and diagnoses and to compare the mortality rate with that of the general population. METHODS: The stud...

  3. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available Reverse Shoulder Arthroplasty Zimmer, Inc. New York City, New York March 17, 2010 Welcome to this OR Live presentation, brought to you by Zimmer. Hi. I'm ... my partner, Brad Parsons. We're here in New York to bring you a video of a ...

  4. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... a good result, but you also run the risk of getting a very stiff, or a flail shoulder that can't be lifted, although the re-operation rate is low. What's come out the studies by ...

  5. Adhesive Capsulitis (Frozen Shoulder)

    Science.gov (United States)

    ... Reaching: Put things you use every day (shoes, coffee cup, toothbrush) on a high shelf. This way you have to reach up for things more often. The reaching is a good stretch for your shoulder. Do the exercises once or twice a day even after your ...

  6. COMPARING EFFECT OF SHOULDER CUFF SUPPORT VERSUS SHOULDER STRAPPING IN PREVENTING POST STROKE SHOULDER PAIN

    Directory of Open Access Journals (Sweden)

    Parvinder kaur

    2013-10-01

    Full Text Available Aims and Objectives:The aim of research is to compare the effectiveness of shoulder cuff support versusshoulder strapping.Methodology:A sample of 20 strokesubjects was recruited for the study. The subjectwere randomly dividedin to 2 groups Group A ( shoulder cuff group and Group B (shoulder strapping group.Pre test assessment was done by Visual analogue scale & pain free range of motion to 900degree. A receivedshoulder cuff and group B received shoulder strapping in their rehabilitation protocol. Both groupwere treatedfor 7 days . on seventh day reading were taken for both groups.Results:Development of pain and restrictionof shoulder range is significantly less in group A- shoulder cuff group as compare to group B -shoulder strappinggroup on 7thtreatment day.Discussion:Use of shoulder cuff support with stroke patients particularly in theearly flaccid stage useful in preventing shoulder pain. Support of the flaccid shoulder early in management canreduce the incidence of subluxation.Strapping would not ensure support to the soft tissueall thetime, and itmay encourage some abnormal synergy pattern.Conclusions:Shoulder cuff support significantly decrease theonsetand intensity of pain in affected upper extremity and prevent restriction of range of motion .ascomparedto shoulder strapping.

  7. Milwaukee Shoulder-Knee Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Nuri Çetin

    2008-06-01

    Full Text Available Basic calsium phospate crystals frequently may form asymptomatic deposits that may give rise to several clinical syndromes, including calsific periarthritis, tendinitis, bursitis, Milwaukee shoulder syndrome, osteoarthritis, calcific tendinitis and bursitis, and mixed crystal deposition in and around joints. Milwaukee shoulder syndrome is a well defined clinical entity that can be observed particular in older women. It is a destructive arthropathy associated with the deposition of cristals, rotator cuff tear, and joint instability. Clinical features include pain, swelling and progressive functional impairment.

  8. Shoulder Pain and Common Shoulder Problems

    Science.gov (United States)

    ... problems fall into four major categories: • Tendon inflammation (bursitis or tendinitis) or tendon tear • Instability • Arthritis • Fracture ( ... pain are tumors, infection, and nerve- related problems. Bursitis Bursae are small, fluid-filled sacs that are ...

  9. Trapezius transfer to treat flail shoulder after brachial plexus palsy

    Directory of Open Access Journals (Sweden)

    Diaz Humberto

    2007-01-01

    Full Text Available Abstract Background After severe brachial palsy involving the shoulder, many different muscle transfers have been advocated to restore movement and stability of the shoulder. Paralysis of the deltoid and supraspinatus muscles can be treated by transfer of the trapezius. Methods We treated 10 patients, 8 males and 2 females, by transfer of the trapezius to the proximal humerus. In 6 patients the C5 and C6 roots had been injuried; in one C5, C6 and C7 roots; and 3 there were complete brachial plexus injuries. Eight of the 10 had had neurosurgical repairs before muscle transfer. Their average age was 28.3 years (range 17 to 41, the mean delay between injury and transfer was 3.1 years (range 14 months to 6.3 years and the average follow-up was 17.5 months (range 6 to 52, reporting the clinical and radiological results. Evaluation included physical and radiographic examinations. A modification of Mayer's transfer of the trapezius muscle was performed. The principal goal of this work was to evaluate the results of the trapezius transfer for flail shoulder after brachial plexus injury. Results All 10 patients had improved function with a decrease in instability of the shoulder. The average gain in shoulder abduction was 46.2°; the gain in shoulder flexion average 37.4°. All patients had stable shoulder (no subluxation of the humeral head on radiographs. Conclusion Trapezius transfer for a flail shoulder after brachial plexus palsy can provide satisfactory function and stability.

  10. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

    Full Text Available 【Abstract】Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle. Traumatic injury to serratus anterior muscle itself is very rare. We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male. Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test. Patient was managed conservatively and achieved satisfactory result. Key words: Serratus anterior tear; Scapula; Wounds and injuries

  11. The influence of experimentally induced pain on shoulder muscle activity

    DEFF Research Database (Denmark)

    Diederichsen, L.P.; Winther, A.; Dyhre-Poulsen, P.;

    2009-01-01

    -105A degrees) at a speed of approximately 120A degrees/s, controlled by a metronome. During abduction, electromyographic (EMG) activity was recorded by intramuscular wire electrodes inserted in two deeply located shoulder muscles and by surface-electrodes over six superficially located shoulder...... muscles. EMG was recorded before pain, during pain and after pain had subsided and pain intensity was continuously scored on a visual analog scale (VAS). During abduction, experimentally induced pain in the supraspinatus muscle caused a significant decrease in activity of the anterior deltoid, upper...... trapezius and the infraspinatus and an increase in activity of lower trapezius and latissimus dorsi muscles. Following subacromial injection a significantly increased muscle activity was seen in the lower trapezius, the serratus anterior and the latissimus dorsi muscles. In conclusion, this study shows that...

  12. The influence of experimentally induced pain on shoulder muscle activity

    DEFF Research Database (Denmark)

    Diederichsen, Louise Pyndt; Winther, Annika; Dyhre-Poulsen, Poul;

    2009-01-01

    -105 degrees) at a speed of approximately 120 degrees/s, controlled by a metronome. During abduction, electromyographic (EMG) activity was recorded by intramuscular wire electrodes inserted in two deeply located shoulder muscles and by surface-electrodes over six superficially located shoulder muscles....... EMG was recorded before pain, during pain and after pain had subsided and pain intensity was continuously scored on a visual analog scale (VAS). During abduction, experimentally induced pain in the supraspinatus muscle caused a significant decrease in activity of the anterior deltoid, upper trapezius...... and the infraspinatus and an increase in activity of lower trapezius and latissimus dorsi muscles. Following subacromial injection a significantly increased muscle activity was seen in the lower trapezius, the serratus anterior and the latissimus dorsi muscles. In conclusion, this study shows that...

  13. Anterior tarsaltunnelsyndrom

    DEFF Research Database (Denmark)

    Miliam, Palle B; Basse, Peter N

    2009-01-01

    Anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the extensor retinaculum of the ankle. It may be rare because it is underrecognized clinically.We present a case regarding a 29-year-old man, drummer, who for one and a half year experienced clinical...

  14. Methods on simple radiogaphy of impingement syndrome in shoulder joint

    International Nuclear Information System (INIS)

    To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior 30 deg caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x-ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.=20

  15. Shoulder dislocation in patients older than 60 years of age

    OpenAIRE

    Rapariz Jose; Martin-Martin Silvia; Pareja-Bezares Antonio; Ortega-Klein Jose

    2010-01-01

    Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test) and by imaging testing (X-ray, MRI). ...

  16. Work related shoulder disorders

    DEFF Research Database (Denmark)

    Svendsen, Susanne Wulff; Bonde, Jens Peter; Mathiassen, S.E.;

    2004-01-01

    Aims: To determine quantitative exposure-response relations between work with highly elevated arms and supraspinatus tendinitis, shoulder pain with disability, and shoulder pain without disability. Methods: A cross sectional study was conducted in a historical cohort of 1886 males from three...... occupational groups. Exposure measurements were performed for four consecutive working days in a random sample of 72 currently employed subjects. Individual work histories were obtained by questionnaire and register data. Health status was ascertained by physical examination blinded towards exposure...... and symptoms. Data were analysed by generalised estimating equation and multiple logistic regression with adjustment for potential confounders. Results: For current upper arm elevation above 90°, a duration increment of 1% of the daily working hours was associated with odds ratios of 1.23 (95% CI 1.10 to 1...

  17. Glyceryl trinitrate patches—An alternative treatment for shoulder impingement syndrome

    Directory of Open Access Journals (Sweden)

    Yusuf Assem

    2015-01-01

    Full Text Available Transdermal glyceryl trinitrate patches have been investigated as an alternative therapeutic intervention for a range of tendinopathies, due to the ease of titration of dosage and the ease of their application. Glyceryl trinitrate has been inferred to reduce pain and inflammation secondary to their nitric oxide-producing action. Shoulder impingement syndrome is a soft tissue condition that manifests as anterior shoulder pain, weakness, and difficulty in daily activities. This review will evaluate the efficacy of glyceryl trinitrate patches in treating a variety of rotator cuff tendinopathies related to shoulder impingement, based on human and animal trials, and suggest its practical application in future trials and management.

  18. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... to conventional arthroplasty, we often use a subscap soft tissue takedown, rather than an osteotomy because of concerns ... the tendon. We've learned that this anterior soft tissue repair is critical for the stability of the ...

  19. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... approach tends to be a little bit more cosmetic in the skin lines and also allows excellent ... deficient arthritic who's has either prior rotator cuff surgery and has a good anterior soft tissue envelope ...

  20. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... an anterior look at the glenoid, you're looking down over the top of the cut of ... to the soft cancillus bone. Now, we're looking at a delto-pectoral approach to illustrate the ...