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Results for “Shoulder Dislocation”

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PubMed1992

[Shoulder dislocation and periarthrosis humeroscapularis].

1232 injuries involving shoulder luxations in 1984 were investigated on the basis of the insurance dossier. 1/3 of the injured persons have sequelae: 10.5% habitual tendency to luxation, 9% peritendinitis, 2% omarthritis and 2% a shoulder instability. 1/5 in each case still experience pain and restricted movement. The 108 cases where peritendinitis has occurred following shoulder luxations are shown divided up according to various symptoms. Peritendinitis ankylosis or frozen shoulder represents the major share in almost half of the cases. Various characteristics, complications and risk factors for the possibility of contracting peritendinitis following shoulder luxation are being worked out. In conclusion, the insurance-relevant parameters for peritendinitis after shoulder luxation are shown: in cases with peritendinitis, integrity compensation was awarded 12 times more frequently than in cases without peritendinitis; in the case of shoulder luxation with peritendinitis, the entire insurance benefits were 10 times higher than in cases without peritendinitis.

Adult↗
PubMed1981

Septic arthritis in rheumatoid disease causing bilateral shoulder dislocation: diagnosis and treatment assisted by grey scale ultrasonography.

Signs of sepsis may be obscure in patients with rheumatoid arthritis, particularly in association with long-term steroid therapy. If mortality is to be avoided, a high index of suspicion must be maintained for the diagnosis, and doubtful joints should be aspirated for culture and prompt therapy with the correct antibiotic. In this report a patients with advanced rheumatoid arthritis presented with bilateral shoulder dislocation due to septic arthritis. Ultrasonography was particularly helpful in guiding a 20 G needle to fluid collections with the debris-filled joint capsules and in facilitating successful aspiration. Ultrasound also provided a painless, noninvasive, and safe method of serial assessment of the joints after therapy.

Arthritis, Infectious↗
PubMed2002

Comparison of intra-articular lidocaine and intravenous sedation for reduction of shoulder dislocations: a randomized, prospective study.

BACKGROUND: Acute anterior glenohumeral dislocations have been commonly treated with closed reduction and the use of intravenous sedation. Recently, the use of intra-articular lidocaine has been advocated as an alternative to sedation, since intravenous access and patient monitoring are not required. The purpose of this study was to evaluate the value of local anesthesia compared with that of the commonly used intravenous sedation during the performance of a standardized reduction technique. METHODS: In a prospective, randomized study, skeletally mature patients with an isolated glenohumeral joint dislocation and no associated fracture were randomized to receive either intravenous sedation or intra-articular lidocaine to facilitate reduction of the dislocation. Reduction was performed with the modified Stimson method. The two groups were compared with regard to the rate of successful reduction, pain as rated on a visual analog scale, time required for the reduction, time from the reduction until discharge from the emergency department, and cost. RESULTS: Thirty patients were enrolled in the study. Five (two in the lidocaine group and three in the sedation group) required scapular manipulation in addition to the Stimson technique to reduce the dislocation. The lidocaine group spent significantly less time in the emergency department (average time, seventy-five minutes compared with 185 minutes in the sedation group, p < 0.01). There was no significant difference between the two groups with regard to pain (p = 0.37), success of the Stimson technique (p = 1.00), or time required to reduce the shoulder (p = 0.42). The cost of the intravenous sedation was $97.64 per patient compared with $0.52 for use of the intra-articular lidocaine. CONCLUSIONS: Use of intra-articular lidocaine to facilitate reduction with the Stimson technique is a safe and effective method for treating acute shoulder dislocations in an emergency room setting. Intra-articular lidocaine requires less money, time, and nursing resources than does intravenous sedation to facilitate reduction with the Stimson technique.

Adolescent↗
PubMed2000

Arthroscopic lavage speeds reduction in effusion in the glenohumeral joint after primary anterior shoulder dislocation: a controlled randomized ultrasound study.

Recent studies have shown that arthroscopic lavage of the glenohumeral joint within 10 days following a primary anterior dislocation significantly lowers the recurrence rate when compared with a nonoperative regime. We hypothesize that the lavage reduces distension in the joint and thereby facilitates adaptation and healing of the soft tissue lesion. Using ultrasound, we assessed the hemarthrosis in the glenohumeral joint weekly in 16 consecutive patients after traumatic primary anterior shoulder dislocation. The patients were randomized into two groups for treatment with either arthroscopic lavage or a nonoperative regime. Except for the lavage the two groups followed an identical rehabilitation program. Transversal dorsal ultrasound of the glenohumeral joint was performed, in which the joint effusion was assessed as the distance between the humeral head and the glenoid. Prior to the lavage the two groups had a similar amount of excessive joint effusion. The effusion declined to a steady state level within 3-7 weeks. The joint effusion decreased more rapidly (33%) in the group treated with arthroscopic lavage (P = 0.02) than in the nonoperated group.

Adolescent↗
PubMed1994

[Dynamic arthro-CT in the diagnosis of recurrent shoulder dislocations].

"Dynamic" double contrast arthro-CT in internal and external rotation was performed on 42 patients with recurrent subluxation of the shoulder. The differential distribution of contrast and air caused by the rotation resulted in optimal demonstration of the capsulo-labrale components responsible for joint stability. In 22 patients there appeared to be an indication for arthroscopy; this confirmed the previous findings. In all cases the anterior part of the capsule and the middle and lower labrum were seen best during internal rotation. In this way all the 15 anterior capsule lesions could be seen, as well as 16 out of 17 Bankart lesions; it also showed one lesion of the middle labrum which had been masked by a haemarthrosis during external rotation. The study also defined lesions of the upper labrum caused by a different pathological mechanism which was present in 7 patients (6 Andrews and 1 S.L.A.P. lesion). These and 2 posterior labrum tears could be diagnosed during external rotation. Sensitivity for lesions of the anterior labrum was 95%.

Adolescent↗