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At least 739 records · Page 41Linked to original sources
PubMed1986

[Treatment of recurrent anterior dislocations of the shoulder by the technic of pre-glenoid stapling. Study of a series of 48 cases].

Preservation of local muscular structures, and closure of the capsulo-periosteum detachment, are the two essential principles observed, when treating recurrent anterior shoulder dislocation by pre-glenoid stapling and also afford satisfactory results. This technique is used for capsulo-ligamentar lesions without alterations of the anterior edge of the glenoid cavity. If the strict technique is followed when placing the staple excellent stability result. If physiotherapy is started early, functional recovery is rapid. Sporting activities can be resumed within the third month after the operation.

Adult↗
PubMed1993

Missed posterior fracture dislocation of the shoulder. Closed reduction and pinning.

In four missed posterior shoulder dislocations, a trial of closed reduction was successful, but severe instability required further therapy. The glenohumeral joints were immobilized by 3 to 4 percutaneously inserted threaded pins. Removal of the pins after 4 to 6 weeks was followed by physiotherapy. After a follow-up of 4 to 42 months, the functional results of this simple procedure are good and there is no recurrence. Bending of the ends of the pins, a very careful follow-up to deal with pin migration, and adequate prevention of subsequent convulsions in epileptic patients are mandatory.

Adult↗
PubMed1996

Open anterior dislocation of the shoulder.

Open dislocation of the shoulder is a rare injury. We report the case of an open shoulder dislocation in a 15-year-old boy. After 15 months his pain was mild and function fair, but radiographs revealed severe destruction of the humeral head though to be secondary to avascular necrosis. Other reported cases of this injury are discussed.

Accidents, Occupational↗
PubMed1996

Arthroscopic management of recurrent anterior dislocation of the shoulder: analysis of technical modifications on the Caspari procedure.

Arthroscopic treatment was performed on 71 patients with recurrent shoulder dislocations; all of the patients had monoplanar anterior instability attributable to arthroscopically diagnosed Bankart lesion. Of the 71 operations, 29 were performed using the original Caspari technique (follow-up, 59 months), and 42 were performed after modifications made in the original technique (follow-up, 38 months), notably improved preparation of the capsular reinsertion zone and increase in the number of monofilament points and their anchorage directly to the bone, on the spine of the scapula. We compared the results obtained in these two differently treated groups, taking into account several factors in the patient's history and clinical condition. These included the number of dislocation episodes before the operation, as well as clinical findings regarding stability, movement, function and pain (Rowe scale score), contralateral shoulder laxity, level of preoperative versus postoperative athletic activity, and postoperative recurrence rate. In the Caspari-treated group, we obtained 66% satisfactory results compared with the 90% obtained in the second group. The recurrence rate was 27% in the first group compared with 4.8% in the second group. These data were statistically significant. No correlation was found between preoperative number of dislocations and recurrence rate, nor for contralateral shoulder laxity. No significant difference was found regarding resumption of sport activity in the two groups. Our data indicate that, with accuracy in patient selection and effective surgical technique, the recurrence rate can be reduced, and results similar to those of the arthrotomic technique may be obtained.

Adolescent↗
PubMed1987

The treatment of unreduced dislocation of the shoulder. A review of 12 cases.

The clinical and radiographic features and the results of treatment are analysed in 12 cases of shoulder dislocation (5 anterior and 7 posterior) in which the dislocation had been present for periods ranging from 3 weeks to 6 months. The follow-up ranged from 9 months to 16 years. Anterior dislocations are easily diagnosed on anteroposterior radiographs. Posterior dislocations may be suspected clinically because of the position of the limb in internal rotation and loss of external rotation, but can easily be missed on A.P. films, which show only a flattened appearance of the humeral head. A definite diagnosis is obtained only with a lateral (axillary) projection. All the anterior dislocations in our series were uncomplicated, but 4 of the posterior dislocations were associated with fractures of the humeral head and/or the greater tuberosity. Two of the 5 anterior dislocations were treated with physiotherapy and remedial exercises alone, while 2 were successfully reduced by manipulation; in the only patient submitted to surgery, ablation of the humeral head was performed. Results were excellent in one of the 2 patients treated with physiokinesitherapy where dislocation had been reduced spontaneously (the only such case described in the literature), and in one of the two cases submitted to nonoperative reduction of the dislocation. Results were good in the second patient subjected to nonoperative reduction and in the patient operated on. All 7 cases of posterior dislocation were treated surgically: in 3 cases the dislocation was reduced, in one the humeral head was removed, in one a partial shoulder prosthesis was applied, and in 2 cases the whole of the proximal extremity of the humerus was resected. In the latter 2 cases the results were poor and fair respectively, while in the remaining cases the results were good. The best surgical treatment of inveterate dislocations is reduction of the dislocation, which in the posterior forms requires a wide antero-supero-posterior approach. The alternative to surgical reduction is the application of a shoulder prosthesis, the result of which (as in resection of the humeral head) is related to the integrity of the greater tuberosity and the rotator cuff.

Adult↗
PubMedDate not supplied

Strength of the glenoid labrum and adjacent shoulder capsule.

This study evaluates the role of the glenoid labrum and capsule in the prevention of shoulder dislocation. Fifteen shoulder joints from nine fresh cadavers were used. The labrum and capsule were cut into sections 5 mm wide, and the strength of each slice to rupture was measured. The rupture site was observed microscopically. The anterior-inferior portion was the weakest, with a mean force necessary to cause rupture of 3.84 +/- 1.00 kg/5 mm. The rupture site was the portion of the labrum close to the cartilage of the glenoid. Histologic structure and degenerative changes of the labrum did not differ in the anterior to posterior portions. These results show that the anterior-inferior portion of the labrum is relatively weak. This finding may explain the lesion commonly identified in anterior shoulder dislocation.

Aged↗
PubMed1990

Recurrent anterior dislocation of shoulder joint.

111 patients with fresh dislocation of shoulder joint were treated with modified Putti-Platt procedure. Of these, 17 had recurrent anterior dislocation. 13 patients were followed up on the average for 25 years. According to Rowe criteria, 10 patients (76.9%) showed excellent results, 2 (15.4%) good, and (7.7%) fair. No recurrence and restriction of external rotation were found. Clinical experience and fetal investigation on congenital factors of recurrent shoulder dislocation were described.

Adolescent↗
PubMed2006

[Radiographic diagnosis of dislocated inverted shoulder prosthesis: two cases of unrecognized dislocation].

Dislocation of inverted shoulder prostheses are rarely described in the literature. Diagnosis is relatively difficult as illustrated by two cases reported here which went unrecognized. The problem is the absence of any clear clinical sign of dislocation and the rather difficult interpretation of the radiographic images. We propose a method for analyzing the radiographic images which can be used to confirm the absence of dislocation on the AP view.

Diagnosis, Differential↗
PubMedDate not supplied

Histologic evaluation of the shoulder capsule in normal shoulders, unstable shoulders, and after failed thermal capsulorrhaphy.

BACKGROUND: Attenuation of the shoulder capsule has been noted during revision surgery for failed thermal capsulorrhaphy. HYPOTHESIS: The attenuated capsule seen in patients who have undergone failed thermal capsulorrhaphy will show histologic characteristics distinguishing it from the capsule of normal shoulders and dislocating shoulders. STUDY DESIGN: Case control study. METHODS: The shoulder capsules were studied in 12 patients with traumatic anterior instability and in 7 patients who experienced recurrent instability after a thermal capsulorrhaphy. The capsules of six fresh-frozen cadavers with no shoulder lesions were used as controls. RESULTS: Among patients who had a history of traumatic instability, a denuded synovial layer was present in 58%, subsynovial edema in 58%, increased cellularity in 25%, and increased vascularity in 83%. At the time of surgery, five of seven shoulders in the failed thermal capsulorrhaphy group (71%) were subjectively felt to be thin and attenuated. Denuded synovium was found in 100% of these patients, subsynovial edema in 43%, and changes in the collagen layer in 100%. Changes in the collagen layer in these patients included a "hyalinization" appearance in five cases (71%), increased collagen fibrosis in two cases (29%), and increased cellularity in two cases (29%). CONCLUSIONS: There was no one characteristic observable on histologic evaluation that would explain the attenuation of the capsule in cases of failed thermal treatment. Morphologic collagen structure can be histologically abnormal for up to 16 months after thermal capsulorrhaphy.

Adolescent↗