Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DISLOCATIONS”

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 343 records · Page 19Linked to original sources
PubMed1990

[Computed tomography in untreated congenital hip dislocation in adolescence].

Untreated cases of congenital dislocation of the hip (CDH) in the adolescent age are rarely encountered in the western world but are not uncommon in our clinical practice. The pathoanatomy has not been well studied. Previously poor results of operative treatment are partially related to this lack of understanding of the true pathoanatomy and the failure to select the appropriate modality of treatment. Computed tomography (CT) has the capability to show the three-dimensional structure and was used in this study. From September 1985 to July 1988, we had 15 patients (18 dislocated hips) for CT study. Their ages ranged from 8 years 6 months to 22 years 5 months. The patients were divided into 4 types according to the position of dislocation, formation of pseudojoint and size of the true acetabulum: (1) high dislocation without pseudojoint formation; (2) high dislocation with pseudojoint formation; (3) low dislocation with pseudojoint formation; and (4) wide acetabulum. By measuring the diameter of the true acetabulum and femoral head, and the anteversion of the true acetabulum and proximal femur, we had the following results: (1) the size of the acetabulum and femoral head in dislocated hips were smaller than the normal side; (2) most of the acetabula in the dislocated hips were still large enough to accommodate the corresponding femoral heads, even up to the age of 22 years; and (3) the degree of anteversion was similar between the acetabula in normal and dislocated hips, but was more prominent in the proximal femur of a dislocated hip than the normal side.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗
PubMed1989

[Shoulder dislocation and -subluxation].

The diagnosis and treatment of shoulder instability require basic differentiation between unidirectional, multidirectional, and voluntary dislocation. Within unidirectional instability primary dislocation, recurrent dislocation, and recurrent subluxation need to be considered separately.--Primary dislocation: In 160 patients with primary dislocation a follow-up was done by questionnaire. In the case of atraumatic primary dislocation the redislocation rate was 100%. Predisposing factors inherent in the bony, cartilaginous, and capsular components of the joint favoured the tendency of primary dislocation. In the case of traumatic primary dislocation the redislocation rate was lower after immobilisation of the joint than without when it had not been immobilised.--Recurrent subluxation: In 52 patients with a clinical diagnosis of recurrent subluxation a tear of the glenoid labrum was found by arthroscopy. In 21 cases the detached labrum was refixed arthroscopically and in 18 cases the repair was done by an open Bankart procedure. Seventy-two percent of the patients who underwent arthroscopic repair showed good to excellent results. In all cases but one in which the Bankart procedure was applied the results were excellent.--Recurrent dislocation: Since 1984 a total of 183 patients were operated on for recurrent shoulder dislocation. All these patients were examined preoperatively by CT scan. The CT findings were used in selection of the appropriate procedure. In 114 patients the Bankart procedure was applied and in 39 cases, a bone-block method. The remaining patients were subjected to various other procedures. Not one of the patients showed postoperative redislocation. (ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Radiocarpal dislocation--classification and rationale for management.

Radiocarpal dislocation is a rare injury. The authors reviewed seven cases with this injury and identified two groups of patients. Type I involves a dislocation of only the radiocarpal joint, while Type II involves intercarpal dislocation also. Four patients were included in Type I dislocation (3 dorsal and 1 volar). The other three patients had Type II dislocations, all of which were volar dislocations. Two patients had evidence of injury to the median and ulnar nerves at the time of the injury and both recovered completely. Closed reduction was possible with good results in three patients with Type I dislocation. All patients with Type II dislocation required open reduction and all had residual problems. The distinction between Type I and Type II is essential in order to evaluate the full extent of the injury. Closed reduction should always be attempted in Type I dislocation. Type II dislocation should be treated by open reduction and repair of all torn ligaments.

Adult↗
PubMed2003

Imaging dislocations in ice.

Three techniques have been used to study dislocations in ice: etch pitting-replication, transmission electron microscopy, and X-ray topography (XT). It is shown that, because ice is a weak absorber of X-rays and can be produced with a low dislocation density, allowing relatively thick specimens to be studied, the most useful technique is XT. The observations that have been made with conventional XT are briefly outlined. However, the introduction of high-intensity synchrotron radiation, with its concomitant short exposure times, showed that images obtained through conventional XT observations were of dislocations that had undergone recovery. The important dynamic observations and measurements that have been made using synchrotron X-ray topography are presented. Dynamic synchrotron X-ray topography observations of ice single crystals undergoing deformation in situ have shown that slip mainly occurs by the movement of screw and 60 degrees (1/3) [1120] dislocations on the basal plane, although non-basal slip by edge dislocations can also occur. The operation of Frank-Read and other dislocation multiplication sources have been clearly demonstrated and dislocation velocities have been measured. In contrast, in polycrystals, dislocation generation occurred at grain boundaries where there are stress concentrations before lattice dislocation generation mechanisms operate. Faulted dislocation loops have been determined to be mainly interstitial in both polycrystals and single crystals.

Crystallization↗
PubMed1998

Manipulation for cervical spinal dislocation under general anaesthesia: serial review for 4 years.

Manipulation under anaesthesia is an important method to reduce cervical spinal dislocations in the acute stage. Causes of failure have not been clearly identified and neurological complications can be the major concern. All cervical dislocations have been traditionally treated by manipulation under anaesthesia in the Christchurch Spinal Injuries Unit as the primary treatment. We reviewed all 31 patients treated from 1991-1995, with detailed documentation of neurological progression and final outcome. Three patterns were identified: bilateral dislocation, unifacet dislocation and fracture dislocation. Most of the dislocations (74%) were successfully reduced by manipulation alone with minimum complications. The remaining 26% patients required open reduction. The predominant causes of failure of reduction by manipulation were co-existing fractures. The success rate of reduction by manipulation was 90% for pure bifacet and unifacet dislocations, but was only 22% for the fracture dislocations. The study concluded that manipulation under anaesthesia is a safe and effective procedure for pure cervical spinal dislocations. Fractures related to the dislocation should be identified early and open reduction be considered.

Adolescent↗
PubMed2004

Visualization of dislocation dynamics in colloidal crystals.

The dominant mechanism for creating large irreversible strain in atomic crystals is the motion of dislocations, a class of line defects in the crystalline lattice. Here we show that the motion of dislocations can also be observed in strained colloidal crystals, allowing detailed investigation of their topology and propagation. We describe a laser diffraction microscopy setup used to study the growth and structure of misfit dislocations in colloidal crystalline films. Complementary microscopic information at the single-particle level is obtained with a laser scanning confocal microscope. The combination of these two techniques enables us to study dislocations over a range of length scales, allowing us to determine important parameters of misfit dislocations such as critical film thickness, dislocation density, Burgers vector, and lattice resistance to dislocation motion. We identify the observed dislocations as Shockley partials that bound stacking faults of vanishing energy. Remarkably, we find that even on the scale of a few lattice vectors, the dislocation behavior is well described by the continuum approach commonly used to describe dislocations in atomic crystals.

Journal Article↗
PubMed1996

Dislocations and the femoral head size in primary total hip arthroplasty.

The dislocation rate of 3197 Charnley prostheses with 22 mm head in which the surgery was done between 1979 and 1991 in 2 orthopaedic centers was compared with that of 2875 Lubinus prostheses with 32 mm head in which the surgery was done between 1980 to 1991 in 3 other centers. A 1-year followup showed an equal rate of dislocation (2.4%-2.5%) in the 2 groups and included 75% of the 201 dislocated hips. Almost all of the late dislocations occurred with the Charnley prosthesis, resulting in a total dislocation rate of 3.7% compared with 2.9% with the Lubinus prosthesis. Regardless of the type of prosthesis used, there was a higher risk of dislocation in patients with nonhealed hip fractures and in arthroplasties performed by less experienced surgeons. When these 2 variables were removed, the small femoral head was not associated with an increased risk of dislocation. However, there were 77 of 118 (65%) recurrent dislocations in the Charnley group, compared with 37 of 83 (45%) in the Lubinus group, and the relative risk of a dislocated hip arthroplasty becoming recurrent increased by 2.3 times if the small femoral head was used. The number of reoperations also were doubled in this group. Almost 4 times as many dislocations were documented within 2 weeks after surgery after any type of prosthesis inserted through a posterior approach compared with the transtrochanteric approach, but there was no increase in rate of recurrence or revision.

Aged↗
PubMed1995

Traumatic hip dislocation: early MRI findings.

PURPOSE: Objective of this study was to present the spectrum of early magnetic resonance imaging (MRI) findings following traumatic dislocation of the femoral head, and to identify any associated injuries that may have therapeutic or prognostic significance and be better delineated by MRI than by conventional radiography. PATIENTS AND METHODS: Prospective MRI of both hips was formed on 18 patients (14 male, 4 female; age range 14-54 years; average age 30.5 years) within 5 weeks of a traumatic femoral head dislocation. The interval between the time of injury and the time of injury and the imaging studies ranged from 2 to 35 days (average 13.2 days). Posterior dislocation was present in 14 patients and anterior dislocation in 4 patients. In the majority of cases, we performed axial T1, coronal T1, and coronal T2* (MPGR) sequences. Images were retrospectively evaluated by consensus of three radiologists for possible abnormalities of the bone and cartilage, joint space, and soft tissues. Because all patients were treated with closed reduction, surgical correlation was not obtained. RESULTS: All patients had a joint effusion or hemarthrosis. Of the 14 patients with posterior dislocation, isolated femoral head contusions (trabecular microfractures) were identified in 6 patients. Four patients had small femoral head fractures, and one had an osteochondral defect. Acetabular lip fractures were seen in six patients, and one patient had a labral tear. Four patients had intra-articular loose bodies and one had ligamentum teres entrapment. Twelve patients had iliofemoral ligament injury. All patients had muscle injury involving the gluteal region and medical fascial compartment, and 13 patients had anterior fascial compartment muscle injury. Seven patients with posterior dislocation had posterior fascial compartment injury. Of the four patients with anterior dislocation, two had bony contusion, two had cortical infraction, one had a labral tear, and all four had an iliofemoral ligament injury. All four patients in this group had muscle injury of the gluteal region and of the anterior and medial fascial compartments. CONCLUSIONS: MRI can effectively identify and quantify the muscle injury and joint effusion that invariably accompany traumatic hip dislocations. It is also useful for demonstrating trabecular bone contusion (trabecular injury) and iliofemoral ligament injury, which occur commonly with acute hip dislocation.

Acetabulum↗
PubMed1985

[Apropos of 87 dislocations of total hip prostheses].

Eighty seven dislocations were seen in 1571 consecutive total hip replacements, mostly performed through a posterior approach. Nine occurred immediately after operation and most of the remainder within 5 weeks. In 26 cases further dislocation occurred, and in 11 patients another operation was required. The 87 dislocated hips have been compared with the remaining 1484. Factors predisposing to dislocation included revision operations, the experience of the surgeon and proper reconstruction of the abductor musculature. When the hip was deemed unstable at the end of an operation, dislocation occurred on 18 occasions out of 20 such cases. The position of the components in the dislocated hips was compared with that in 100 stable prostheses chosen by random sampling. A vertical acetabular prosthesis, and retroversion of the acetabular and femoral components all favoured dislocation. In 331 replacements with a 22 mm diameter head 29 dislocations were seen (8.7%), whereas in 168 replacements with 32 mm heads, 5 dislocations occurred (2.9%).

Hip Dislocation↗
PubMed1998

[Botulinum toxin treatment of neurogenic dislocation of the temporomandibular joint].

Botulinum toxin leads to paresis of the skeletal muscle lasting 2-4 months via an inhibition of acetylcholine release at the neuromuscular junction. Since 1995, botulinum toxin injections have been used in the treatment of recurrent dislocation of the temporomandibular joint (TMJ). The chemical denervation of the external pterygoid muscle restricts the angle of mouth opening, thus helping to prevent dislocation. TMJ dislocations that occur as a result of increased tone in the protracted masticatory muscles were recently defined as neurogenic dislocations of the TMJ. We conducted a clinical study to investigate the efficacy of botulinum toxin injections into the external pterygoid muscle in five patients with recurrent neurogenic dislocations of the TMJ. In the 3 months prior to the first treatment, the patients had suffered a total of 19 dislocations. In the 3-month period following the initial treatment, only one woman experienced a dislocation. We performed the treatment a total of 25 times. Five dislocations occurred during the 6- to 36-month observation period. In the meantime, two patients remain recurrence-free 1 year after receiving treatment. All the patients had a restricted ability to open their mouths as a side effect of the weakening of the external pterygoid muscle that was completely reversible over the course of 3-4 months. All other side effects were equally well-tolerated by the patients and fully reversible after 3 weeks at the most. In the two patients who remain recurrence-free without any further treatment, the increased tone of the muscles serving the jaw normalised spontaneously over the course of the underlying neurological disease. Our results show that, in the treatment of recurrent neurogenic dislocations of the TMJ, botulinum toxin injections represent a therapeutic alternative that has few side effects.

Adult↗
PubMed2005

A long-term follow-up study after medial patellofemoral ligament reconstruction using the transferred semitendinosus tendon for patellar dislocation.

The management of patellar dislocation syndrome has traditionally been difficult. There are no golden standard methods for patellar dislocations probably due to the many etiologies. However, it is known that medial patellofemoral ligament (MPFL) is damaged when the patella is dislocated. The purpose of this study is to examine whether our method of MPFL reconstruction is useful for the treatment of dislocated patellae and unstable patellae. Forty-six knees (43 patients) of 68 knees (65 patients) that were operated on using our surgical procedure for MPFL reconstruction with the advancement of the vastus medialis or the MPFL reconstruction with Insall's procedure were followed up for at least 5 years. The patient age ranged from 6 to 43 years. These knees consisted of six habitual dislocation patellae, twenty-six recurrent dislocation patellae, ten traumatic dislocation patellae, and four unstable patellae. The patients were evaluated pre-operatively and more than three times post-operatively at 6, 12, 36, 60, or 120 months. No patient experienced patellar dislocation after surgery. Their post-operative Kujala's scores were significantly improved. On conventional X-ray and on stress X-ray evaluations, the mean values for congruence angle, tilting angle, lateral shift ratio, medial stress shift ratio, and lateral stress shift ratio at the final follow-up (60 or 120 months) were demonstrated to be within the normal range. We conclude that our MPFL reconstruction method with the advancement of the vastus medialis or with Insall's procedure might be recommended for the treatment of habitual, recurrent, and indeed any other type of patellar dislocation, as well as for unstable patellae.

Adolescent↗
PubMed2003

The incidence of dislocation after primary total hip arthroplasty using posterior approach with posterior soft-tissue repair.

BACKGROUND: Dislocation after total hip arthroplasty (THA) is one of the most common major complications, and occurs more often through a posterior approach. We performed a retrospective study to determine the incidence of early dislocation and the relationship to the type of prosthesis and the surgeon's experience. METHODS: A group of 884 consecutive primary THAs (746 cemented and 138 cementless) approached through a posterior incision with repair of the posterior soft tissues was followed for a mean of 30 months. RESULTS: The overall dislocation rate was 1.36% (cemented: 1.1%; cementless: 2.9%). All dislocations were posterior and occurred within 6 months after surgery, 91% within 6 weeks. Dislocations were most common in rheumatoid patients (3.8%). Two revisions (0.23%) of the acetabular cup were performed for recurrent dislocations. The dislocation rate was not higher in the operations performed by less experienced surgeons. CONCLUSION: The early dislocation rate after primary THA through a posterior approach with repair of the posterior soft tissues was low, especially in cemented THA. Less experienced surgeons were not associated with a higher dislocation rate.

Adult↗
PubMed2006

Traumatic manubriosternal dislocation.

Manubriosternal dislocation is an extremely rare occurrence, especially as the result of an indirect compression injury. Manubriosternal dislocations are divided into two types: In a Type I dislocation, the body of the sternum is displaced in a dorsal direction; in Type II dislocation, the body is displaced to the ventral side of the manubrium. A manubriosternal dislocation may be caused by direct or indirect trauma. Direct injury is generally a collision injury occurring in the context of a road accident. Resulting may be in either a Type I or Type II dislocation. Indirect trauma always leads to a Type II dislocation due to a flexion-compression mechanism in the region of the spine. Rheumatic arthritis and obvious kyphosis are predisposing factors in manubriosternal dislocation due to the indirect compression injury. Non-operative treatments after reduction, e.g. correction tape or plaster bandage, symptomatic pain treatment, application of ice, and several weeks without sports, are associated with a not inconsiderable rate of subluxations or reluxations, especially due to insufficient patient compliance. These disorders can lead to chronic pain, periarticular calcification with ankylosis, and progressive deformity. It has not been possible to establish an optimal, standardized operative procedure so far because of the small number of cases. We have achieved very good, postoperative long-term outcomes after plate osteosynthesis of manubriosternal dislocations in two patients.

Accidental Falls↗
PubMed2004

[Role of sagittal spinal curvature in early dislocation after revision total hip arthroplasty: prospective analysis of 49 revision procedures].

PURPOSE OF THE STUDY: Hip dislocation after revision total hip arthroplasty (RTHA) is a frequent post-operative complication. Certain risk factors are well identified (nonunion of the greater trochanter, history of recurrent dislocation or infection, multiple procedures), the role of spine morphological remains to be fully examined. The purpose of this prospective analysis was to assess the role of spine morphology in post-operative dislocations. MATERIAL AND METHODS: Forty-nine patients who underwent RTHA between September 2002 and March 2002 were evaluated prospectively. A complete pre- and postoperative spinal work-up was available for all patients to evaluate the lumbopelvic static using the Legaye and Duval Beaupère morphology criteria and the pelvic-femoral angle to assess hip joint extension. Pre-, per- and post-operative data including the usual risk factors for dislocation related to the clinical situation and the technique used were recorded on a digital datasheet. Five patients developed postoperative dislocation despite the absence of defective implant position. There was no relation with access (p=0.832) or pelvic-femoral angle (p=0.515). RESULTS: The mean value of the sacral slope was significantly different (p=0.006) in patients who developed dislocation in comparison with the other patients. This difference remained significant (p=0.017) for the cohort of 33 patients who had no associated risk factor for postoperative dislocation (history of recurrent dislocation or infection, multiple procedures, tight nonunion of the greater trochanter). DISCUSSION: Our results suggest that the morphology of the lumbar spine can be involved in the risk of postoperative dislocation. The morphology of the lumbar spine affects the pelvic static and thus the landmarks usually used for implantation, but it can also limit the amplitude of pelvic movement when changing from the sitting to the standing position, which would be compensated for by greater hip movement, particularly extension. The method we used did not fully take into account the consequences of changes in spinal balance due to thoracic deformations nor to analgesic (or not) hip flexion and subsequent deformation of the lumbar spine.

Hip Dislocation↗
PubMed2002

Current concepts of lateral patella dislocation.

Surgical treatment of patellar dislocations, acute and chronic, has evolved significantly over the past decade with the advance of biomechanical knowledge of patellofemoral restraints and injury patterns identified by physical examination and improved imaging techniques. There continues to be no consensus on treatment parameters. Despite the presence of predisposing factors, such as dysplasia or generalized hyperlaxity, medial retinacular injury associated with primary (first-time) patellar dislocations represents a ligament injury, which may result in residual laxity of the injured structure. This residual laxity is defined objectively by an increase in passive lateral excursion of the patella. Repair or reconstructive procedures to restore this medial constraint is considered paramount in any procedure to stabilize the patella against subsequent dislocations. How best to accomplish this continues to be a matter of debate. The establishment of a medial check-rein by either repairing or reconstructing the MPFL is the procedure of choice for stabilizing a kneecap after first-time dislocation, largely because the literature to date does not provide clear guidelines about when more extensive surgery is indicated. Whether or not all first-time dislocators have improved outcome after surgical repair remains speculative, however. Improved outcome would involve both the elimination of recurrent instability episodes and continued satisfactory function of this patella in activities-of-daily-living and sporting activities. These outcomes have not been studied critically in operative versus nonoperative treatment of first-time patellar dislocation. For the first-time dislocator, most investigators would agree that an arthroscopy should be performed if intra-articular chondral damage is suspected. Nonoperative management of first-time patellar dislocations continues to be the preferred practice pattern in the United States. If surgical management is elected, because of individual characteristics of the injury pattern or the patient's lifestyle, it is important to inspect the MPFL along its length and repair any or all ligamentous disruptions. If the ligament is avulsed from the medial epicondyle, reattachment to bone is necessary to restore passive restraint to lateral patella motion. MRI may be useful in order to identify the location and degree of medial soft tissue injury preoperatively. The establishment of a medial check-rein by either repairing or reconstructing the MPFL is a necessary component of all surgical procedures performed to correct objective lateral instability of the patella. The addition of a LRR should be additive to this procedure only when it facilitates other procedures to recenter the patella or when objective lateral tilt by physical examination measurements is present. A practical approach to surgery after patellar dislocation is the minimal amount of surgery necessary to re-establish objective constraints of the patella. Correcting dysplastic factors, in particular tibial tubercle transfers and trochleoplasties, are best reserved if more minimal surgery has failed. This failure is defined as continued functional instability of the kneecap.

Arthroscopy↗
PubMed1996

Dislocation of the extensor tendons over the metacarpophalangeal joints.

Twenty-seven patients who had received treatment for dislocation of the extensor tendons over the metacarpophalangeal joint were reviewed. Sixteen patients had traumatic dislocations, seven had spontaneous dislocations, and four had congenital dislocations. The long finger was most frequently affected. The other fingers were affected almost equally. Displacement of the extensor tendon always occurred in the ulnar direction in the long and ring fingers. The index and little fingers exhibited different patterns of dislocation: two patients had ulnar dislocation of both the common and proprius tendons, and the remaining five patients had divergent dislocation of the two tendons. Nonsurgical treatment was undertaken in six cases. Surgery was performed in 21 cases. No recurrent dislocations were reported in any of the patients. Based on our experience, patients seen within 2 weeks of injury initially should be treated with splinting of the involved metacarpophalangeal joint. Chronic dislocations should be treated with a primary repair of the defect in the sagittal band. When the sagittal band is absent or deficient, the tendon must be stabilized using a loop procedure with a tendon slip.

Adolescent↗
PubMed1982

Dislocations of the proximal interphalangeal joints of the long fingers. Anatomo-clinical study and therapeutic results.

The authors report an anatomo-clinic study on dislocations of the PIP joint in order to point out the lesions and the adequate treatment. This study is composed of two parts: first an anatomoclinical study of 29 dislocations all of which were operated on principle after a clinical and radiographic examination. The second part is a complementary anatomical study of 20 cadaveric joints based on an analysis of the different stabilizing structures of the joint. The study showed that, in order to get a dislocation of the PIP joint, it is necessary that two stabilizing formations be damaged. There is a major lesion and a minor one. The major lesion is characteristic of the type of the dislocation. Anterior dislocations were very rare in this study. The major lesion is a rupture or desinsertion of the central slip of the extensor tendon and the minor lesion is a tear in the collateral ligament. The treatment must be surgical because of the major lesion of the extensor apparatus. Quite different from the anterior lesions are the posterior and the lateral dislocations. They are more frequent. Although they have some similarities, they are, in fact, very different from an anatomoclinical and a therapeutic point of view. In posterior dislocations the major lesion is a rupture of the volar plate. The minor lesion is a partial desinsertion of the collateral ligament. These dislocations are stable after reduction. According to the authors, the best treatment is orthopedic, with a partial immobilization preventing the last degrees of extension. The major lesion in lateral dislocations is a rupture or avulsion of the collateral ligament and the minor lesion is a partial tear of the volar plate. After reduction they are unstable, and thus justify, according to the authors, an operative treatment, especially as they are often associated with cartilaginous lesions.

Adult↗
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↗