Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Shoulder Dislocation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1984

[Development of habitual shoulder dislocation].

The starting point of the retrospective analysis of 177 primary dislocations was the question of frequency of habitual dislocations, the correlation between habitual dislocation and time of early immobilisation, as well as the search for additional statements which would result in a differentiated therapy. 18.1% habitual dislocations were seen to develop, mostly after immobilisation for less than three weeks. It is an interesting fact that the technique of immobilisation made no difference. We found that after the first even there was generally no loss in function, whereas 14.5% of the men and 34.3% of the women complained of severe subjective symptoms. The 12 patients who underwent an operation because of habitual dislocation suffered neither from dysfunction nor from painful movement, and no dislocation was found. The rate of habitual dislocation in our patients showed a lower rate of dislocation of the shoulder joint. We found 18.1% dislocations, whereas the literature showed an average quota of 30%. To improve the results we recommend a special X-ray technique following the first reposition. In the age group between 20 and 30 years, which is most susceptible, we also recommend arthrography and arthroscopy of the shoulder joint. To improve typical lesions, such as osseous rupture of the capsule or what is known as Hill-Sachs lesions, primary operation is discussed as an alternative treatment.

Adolescent↗
PubMed2005

[Simultaneous bilateral ventral and dorsal shoulder dislocation following an epileptic convulsion--a rare combination of injuries].

We report about a 29 year old male patient who had a simultaneous bilateral ventral and dorsal shoulder dislocation. The dislocation happened during a first incident of an epileptic convulsion, previously not diagnosed. On the right shoulder following a closed reduction manoeuvre a dislocation fracture was seen. It needed operative open reduction and fixation with angular stable plate osteosynthesis. The locked dorsal shoulder dislocation on the left was operated dorsally secondary via a dorsal approach. In a first step the reduction was carried out and in the same intervention the humeral head defect was lifted and supported in a closed technique under radiographic control.6 months postoperatively the patient was free of pain in both shoulder joints. The range of motion was unimpeded on the left and only with slight deficits in abduction and anteversion on the right. The diagnostics and the treatment strategy for this rare injury combination are described critically in this paper.

Adult↗
PubMed1994

Nerve lesions in primary shoulder dislocations and humeral neck fractures. A prospective clinical and EMG study.

The incidence of nerve injuries in primary shoulder dislocation and humeral neck fracture is uncertain. We made a prospective study of 101 patients, using clinical examination and extensive electrophysiological assessment when there was suspicion of nerve damage. We found electrophysiological evidence of nerve injury in 45%, most involving the axillary, suprascapular, radial and musculocutaneous nerves. There were significantly more nerve injuries in older patients and those with a haematoma. Most patients recovered partially or completely in less than four months, and only eight had persistent motor loss. Early diagnosis and physiotherapy are recommended.

Adolescent↗
PubMedDate not supplied

Injury of the axillary nerve subsequent to recurrence of shoulder dislocation. Clinical and electromyographic study.

Injuries of the axillary nerve subsequent to recurrence of glenohumeral dislocation have received only minimal attention. It is the purpose of this study to define the prevalence and the progression in time of injury of the axillary nerve in patients with recurrence of anterior shoulder dislocation. For two years we observed a total of 185 patients who had had primary shoulder dislocation. Excluded from the study were patients who had fractures associated with metabolic disorders that favored neurologic deficit. During the period of study, 98 patients contacted us again after recurrence of the dislocation: there were 89 patients aged over 60 years and 9 aged below 60 years. All of the patients were evaluated clinically and submitted to EMG in order to verify the condition of the axillary nerve. Four patients (4%) had neuroapraxia of the axillary nerve. One of these also had neuroapraxia of the radial nerve. Of the four patients, one was a male aged 34 years; the others were all aged over 60 years. In all of the cases, function of the axillary nerve completely recovered after a mean period of 4 months (3-5.3 months) after recurrence. Injury of the axillary nerve can occur at the time of the first recurrence of the injury. However, prevalence is significantly lower than that observed after primary dislocation. The occurrence of this injury should be taken into consideration, particularly in elderly patients, in order to avoid erroneous clinical diagnosis and massive rupture of the cuff subsequent to recurrence of the dislocation.

Adolescent↗
PubMedDate not supplied

A novel cadaveric model for anterior-inferior shoulder dislocation using forcible apprehension positioning.

A novel cadaveric model for anterior-inferior shoulder dislocation using forcible apprehension positioning is presented. This model simulates an in vivo mechanism and yields capsulolabral lesions. The scapulae of 14 cadaveric entire upper limbs (82 +/- 9 years, mean +/- standard deviation) were each rigidly fixed to a custom shoulder-testing device. A pneumatic system was used with pulleys and cables to simulate the rotator cuff and the deltoid muscles (anterior and middle portions). The glenohumeral joint was then positioned in the apprehension position of abduction, external rotation, and horizontal abduction. A 6-degree-of-freedom load cell (Assurance Technologies, Garner, North Carolina) measured the joint reaction force that was then resolved into three orthogonal components of compression force, anteriorly directed force, and superiorly directed force. With the use of a thrust bearing, the humerus was moved along a rail with a servomotor-controlled system at 50 mm/s that resulted in horizontal abduction. Force that developed passively in the pectoralis major muscle was recorded with an independent uniaxial load cell. Each of the glenohumeral joints dislocated anterior-inferior, six with avulsion of the capsulolabrum from the anterior-inferior glenoid bone and eight with capsulolabral stretching. Pectoralis major muscle force as well as the joint reaction force increased with horizontal abduction until dislocation. At dislocation, the magnitude of the pectoralis major muscle force, 609.6 N +/- 65.2 N was similar to the compression force, 569.6 N +/- 37.8 N. A cadaveric model yielded an anterior dislocation with a mechanism of forcible apprehension positioning when the appropriate shoulder muscles were simulated and a passive pectoralis major muscle was included. Capsulolabral lesions resulted, similar to those observed in vivo.

Aged↗
PubMedDate not supplied

[Results of rotation osteotomy using the Weber method in the treatment of habitual shoulder dislocation].

Weber's rotational osteotomy is a surgical treatment of recurrent shoulder dislocation. While eliminating recurrence of the complaint, it attempts to regain full range of movement in the joint. Of the 39 operated patients it was possible to follow up 34 cases. The percentage of recurrent dislocation was 5.7%. The range of movement was reduced in some patients; in one by 10 degrees - 20 degrees. Otherwise there were no significant complications or post-operative complaints. The operative technique, the X-ray procedure and the pathogenesis of the original dislocation are described. Typical accompanying injuries require a particular operative method. The most common accompanying damage was normally the typical defect of the humeral head (incidence 91%). The regular overstretching of the subscapular muscle and the defect of the humeral head are considered by the operational technique introduced by Weber.

Adolescent↗
PubMed2006

Quantitative assessment of glenohumeral translation after anterior shoulder dislocation and subsequent arthroscopic bankart repair.

BACKGROUND: During the past decade, developments in arthroscopic technology have made arthroscopic repair of labral lesions feasible. However, results with the use of the transglenoid suture technique, or with the use of bioabsorbable tacks, have remained variable in the literature, and the recurrence rates are still inferior to those of open Bankart repair. HYPOTHESIS: Arthroscopic Bankart repair with suture anchors can re-create translational and rotational range of motion of the intact glenohumeral joint, and the number of preoperative dislocations has an influence on the result. STUDY DESIGN: Controlled laboratory study. MATERIALS: Twelve cadaveric shoulders were tested in a robot-assisted shoulder simulator. Anterior and posterior translation and external rotation were measured for intact, dislocated (shoulders were randomly selected to 1 of 3 groups, which were dislocated 1, 3, or 7 times), and repaired conditions at 0 degrees and 90 degrees of glenohumeral elevation. RESULTS: After shoulder dislocation, a significant increase was found in translation and rotation, confirming the creation of a traumatic shoulder instability model. Further testing of the specimen revealed that translational and rotational ranges of motion were reduced by arthroscopic Bankart repair at both testing positions. External rotation was decreased significantly at 0 degrees and 90 degrees of abduction. No significant differences were found between the 3 dislocation groups. CONCLUSION: The results demonstrate a sufficient biomechanical performance of arthroscopic Bankart repair using suture anchors in a traumatic anterior shoulder instability model. With the numbers available, no relationship was found between the number of dislocations and the postoperative result concerning translational or rotational motion. CLINICAL RELEVANCE: Glenohumeral translation and rotation after arthroscopic Bankart repair with use of suture anchors approached near normal values, confirming the clinical success of this technique.

Aged↗
PubMed1998

Hill-Sachs lesion in recurrent shoulder dislocation: sonographic detection.

In a prospective study 61 patients with recurrent anterior shoulder dislocation were evaluated by sonography, radiography, and surgery to determine the value of sonography in the detection of a HillSachs lesion. The group consisted of 57 male and four female patients with an average age of 27 years. Hill-Sachs lesion was found in 54 (88%) shoulders of the 61 surgically treated patients. Using surgical findings as the gold standard, we found sonography to be 96% (52 of 54 cases) sensitive, 100% specific (seven of seven cases), and 97% (59 of 61 cases) accurate in the diagnosis of HillSachs lesion. The average size of the lesion measured by sonography was 19.2 mm long, 16.0 mm wide, and 4.1 mm deep. The lesion was of small or medium size (up to 6 mm deep) in 88% of patients. Results of our study show that sonography is a valuable imaging technique in the diagnosis of Hill-Sachs lesion. It produced only two false-negative results when compared with surgical findings.

Adolescent↗
PubMed2001

Abduction-and-horizontal-adduction technique for reduction of acute anterior shoulder dislocations: a simple technique evaluated with radiographs.

Forty-five acute anterior shoulder dislocations were reduced by an abduction-and-horizontal-adduction technique performed in the supine position. Forty-one (91%) of the 45 dislocations were reduced successfully on the first attempt using this technique, without anesthesia or assistance. There were no complications attributed to the technique. To clarify the reduction maneuver using this technique, the procedure was evaluated with radiographs. With horizontal adduction and gentle traction applied at 90 degrees of abduction, the scapula maximally shifted anteriorly with superior rotation, allowing the dislocated humeral head to be reduced. The long head of the biceps tendon seems to have an important role in this reduction technique, along with the musculotendinous units of the rotator cuff.

Adolescent↗
PubMed1982

A modification of the gravity method of reducing anterior shoulder dislocations.

A modification of the gravity method for reducing acute or recent anterior shoulder dislocation has the patient placed on a bed in a comfortable prone position. With the surgeon comfortably seated close to the patient's shoulder, he can talk to the patient, help him relax his deltoid muscle, watch the state of muscle relaxation, and adjust the traction force accordingly. Sustained traction of varying force is possible for long periods, and under a variety of field conditions has shown excellent results.

Gravitation↗
PubMed2001

Arthroscopic repair of acute traumatic anterior shoulder dislocation in young athletes.

PURPOSE: To compare the results of arthroscopic repair in acute anterior shoulder traumatic dislocation with those of nonoperative treatment. TYPE OF STUDY: A prospective nonrandomized study was performed. METHODS: Between August 1989 and April 1997, 46 patients were seen after a first episode of traumatic anterior shoulder dislocation. The average age was 21 years (range, 17 to 27 years). Most dislocations were in rugby players (36 patients). There were 18 patients treated by nonoperative methods and 28 patients treated by acute arthroscopic repair; 22 patients using transglenoid suture and 6 patients with bone anchor suture fixation. RESULTS: Of the patients treated nonoperatively, 94.5% suffered a redislocation between 4 and 18 months (average, 6 months). In the operative group, 96% of the patients (27) obtained excellent results according to the Rowe scale. Only 1 patient suffered a redislocation 1 year after surgery. Three different types of lesions were found during surgery: group I, capsular tear with no labrum lesion (4%); group II, capsular tear with partial labrum detachment (32%); and group III, capsular tear and full anterior labrum detachment (64%). The average follow-up was 67.4 months (range, 28 to 120). There were no surgical complications. CONCLUSIONS: The operative group obtained 96% excellent results, but the nonoperative group only obtained 5.5% excellent results, according to the Rowe scale. The nonoperative group showed a high incidence of redislocation (94.5%) compared with the operative group (4%). Based on the findings of this study, we recommend using an arthroscopic evaluation and repair after an initial anterior traumatic shoulder dislocation in young athletes.

Adolescent↗
PubMed1984

Nerve lesions associated with shoulder dislocation; an electrodiagnostic study of 11 cases.

Electrodiagnostic examination of 11 patients with shoulder dislocation revealed nerve damage not previously reported. Although axillary nerve lesions were most common, posterior cord and musculocutaneous nerve damage occurred each in five cases. The mechanism of injury was important. The most surprising patterns were associated with blunt injury or recurrent spontaneous dislocation.

Adult↗
PubMed2003

Shoulder arthroplasty in patients with a prior anterior shoulder dislocation. Results of a multicenter study.

BACKGROUND: Prior reports of shoulder arthroplasty performed for dislocation-induced arthropathy have included only patients who had had a prior stabilizing procedure. The purpose of this study was to report the results of shoulder arthroplasty in all patients with a prior anterior shoulder dislocation, including both those previously treated operatively and those previously treated nonoperatively. METHODS: Fifty-five shoulders undergoing arthroplasty for arthritis following a prior anterior shoulder dislocation were evaluated. Twenty-seven of the shoulders had undergone a prior anterior stabilization procedure. The measures used to evaluate the shoulders included the Constant score, adjusted Constant score, active mobility, subjective satisfaction, radiographic result, and complications. RESULTS: The shoulders were evaluated at a mean of 45.0 months. The Constant score improved from a mean of 30.8 points preoperatively to a mean of 65.8 points at the time of follow-up. The adjusted Constant score improved from a mean of 38.2% to a mean of 79.8%. Active forward flexion improved from a mean of 82.1 degrees to a mean of 138.9 degrees. Active external rotation improved from a mean of 4.0 degrees to a mean of 38.6 degrees. Fifty patients rated the result as good or excellent. Negative prognosticators included an older age at the time of the initial dislocation and a rotator cuff tear. No significant differences in demographic factors, pre-arthroplasty function, post-arthroplasty function, pre-arthroplasty radiographic findings, post-arthroplasty radiographic findings, complication rate, or reoperation rate were noted between the patients treated with a prior operation for the anterior instability and those treated nonoperatively. CONCLUSIONS: This investigation documented the good results obtainable with shoulder arthroplasty for the treatment of arthritis following anterior shoulder instability. In addition, our findings suggest that capsulorrhaphy-induced arthropathy may be indistinguishable from arthritis following nonoperatively treated anterior shoulder instability.

Adolescent↗
PubMed1999

Recurrent post-traumatic anterior shoulder dislocation--open versus arthroscopic repair.

A total of 41 consecutive patients (11 women and 30 men, median age 29 (18-51) years) with unilateral, isolated, posttraumatic, recurrent anterior shoulder dislocation and a Bankart lesion were operatively repaired, either by an arthroscopic technique including a capsular plication, or by an open procedure with Mitec anchors. All the patients were followed prospectively and evaluated after a median of 36 (30-52) months follow-up by a "blind" observer. Nineteen patients in each group had excellent or good results, and one in each group was graded as fair. One patient in the arthroscopic group had a traumatic dislocation 5 months after the operation and was graded as poor. Three patients experienced subluxations postoperatively, one in the arthroscopic and two in the open group. There was no significant difference in anterior-posterior shoulder laxity measured objectively with Donjoy. The open Bankart repair group had a statistically significantly longer hospitalization (P = 0.001), a slight decrease in external range of motion, and more frequent cosmetic complaints. Apart from this, the results revealed no major differences between the two methods after a median of 36 months in this selected group of patients with longstanding problems.

Adolescent↗
PubMedDate not supplied

Neer capsular shift surgery in the treatment of recurrent antero-inferior shoulder dislocations.

A total of 47 patients affected with recurrent multidirectional shoulder dislocation with a prevalent anteroinferior component were submitted to Neer inferior capsular shift surgery. Bankart lesion, present in 24 patients, was repaired prior to performing capsuloligamentous surgery. The patients included in the study presented with generalized ligamentous hyperlaxity in 20 cases, while hyperlaxity was localized in the pathological shoulder in the remaining cases, presumably related to the high number of dislocations. The choice of performing Neer inferior capsular shift surgery was initially based on the data and the modern conceptions that emerged in the literature. Successively, the good results obtained encouraged us to follow the path taken, and we are currently encouraged to advise this surgical procedure for the category of patients mentioned above.

Adolescent↗
PubMedDate not supplied

Acute bilateral anterior shoulder dislocation following domestic assault--case report.

A rare case of acute bilateral anterior shoulder dislocation in an elderly woman is presented. This injury resulted from domestic physical assault by her daughter inlaw. Patient defaulted after initial treatment--a common practice by patients in our society. This case is being reported to highlight the occurrence of this rare orthopaedic emergency.

Aged↗
PubMedDate not supplied

Chronic shoulder dislocations.

Thirty-two patients with chronic dislocation of the shoulder were diagnosed over a 5-year period at King Edward VIII Hospital, Durban, South Africa. Thirty-one patients had an anterior subcoracoid dislocation. One patient had a chronic posterior dislocation. The duration of dislocation ranged from 6 days to 2 years. Six patients were epileptic, and it was an affliction of all ages. None of the patients had a vascular deficit, but 4 had neurologic damage on presentation. Closed manipulation was only successful in 1 patient. Ten patients' shoulders were left unreduced in the dislocated position. Twenty-one patients, including the patient with a single posterior dislocation, underwent open reduction. The author treated 10 patients with chronic anterior dislocations surgically. The coracoid was transferred to the glenoid, and acromiohumeral K-wire fixation was used for 4 weeks in this group. These 10 cases, as well as 5 cases left unreduced, were followed up for more than 2 years. The results were evaluated by the system proposed by Rowe and Zarins and showed that surgically treated patients fared better than those whose shoulders were left unreduced regardless of the duration of the dislocation or the age of the patient. This series differs from previous reports in several respects. All but one of the dislocations were anterior, the incidence of epilepsy was lower, and successful reduction by manipulation was rarely achieved. In all 10 cases in which the author performed the operation, the shoulder was successfully relocated without neurovascular complications. Dissection of the axillary vessels and nerves was never necessary.

Adolescent↗