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Results of a modified Putti-Platt operation for recurrent shoulder dislocations and subluxations.

In 78 consecutive cases of a modified Putti-Platt operation using an anterior shoulder incision, only on recurrent dislocation occurred in a 19-year-old male athlete who suffered an insulin seizure. All other patients have returned to athletic activity. This study indicates that external rotation is greater if measured with the arm at 90 degrees of abduction. Inasmuch as this is the more functional position for the arm, measurements to determine limitation of shoulder rotation should be done in this position. Results show that there is a definite individual variation in external rotation of the shoulder. The Putti-Platt operation limits external rotation by 12 degrees to 19 degrees as measured at 90 degrees of abduction. This however, has not been a functional problem in any of our patients. The modified Putti-Platt operation is a sound, surgical procedure that gives excellent functional results in an athletic population.

Adolescent↗

[Recurrent shoulder dislocation. On the sports capacity following surgical therapy].

The traumatic dislocation is one of the most seen dislocations of great joints. In 70% it happens to patients during sports and between 20 and 60% of cases are followed by instability of the shoulder. An explorative study informs about case history, postoperative course and sports participation after surgical treatment of recurrent dislocations of the shoulder. Good results of sports participation can be achieved with early diagnostic and therapeutic procedures.

Adolescent↗

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

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.

Adult↗