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[Etiopathogenetic factors of congenital habitual shoulder joint dislocation].

Six of 56 patients (10.7 per cent) surgically treated for anterior habitual and recurrent dislocation of the shoulder joint exhibited congenital habitual dislocation. Surgery revealed agenesis of the anterior and upper parts of the capsular wall. The lower part of the capsular wall was used for reconstruction.

Adolescent↗

Brachial plexus injury in association with fracture-dislocation of the shoulder.

Anterior dislocation of the shoulder is generally not associated with neurological compromise. We report three patients in whom a brachial plexus injury was caused by an anterior dislocation of the shoulder. One patient was further complicated by vascular involvement. The forces producing the injury are usually small, and the neurological trauma is likely to be neuropraxia. Conservative management is usually successful, and, in our patients, recovery took place after an average of six months.

Adolescent↗

Fracture-dislocation of the shoulder in a child: case report.

This is a case of an 11-year old girl with a delayed diagnosis of a shoulder fracture-dislocation. Shoulder dislocations are rare, and proximal humerus fractures are uncommon. A fracture-dislocation in a child is, to our knowledge, as yet unrepresented in the English-language literature. The child's injury resolved without recurrence.

Bone Remodeling↗

[Delayed diagnosis of posterior dislocation of the shoulder].

Posterior dislocation of the shoulder is rare. It may follow trauma, electroconvulsive treatment or an epileptic attack. Correct diagnosis may be delayed, as there is no obvious deformity in the shoulder region and the arm is held in a natural sling position. AP X-ray of the shoulder shows only a few minor signs. A high index of suspicion, proper physical examination, and oblique X-ray views lead to correct diagnosis. Closed reduction is possible if the dislocation is of less than 3 weeks duration. Open reduction is indicated in young patients, and in older patients when there is disability.

Humans↗

[Sports and work capacity after stabilization of recurrent shoulder joint dislocations].

Eighty-one patients (83 shoulder joints) underwent surgical procedures for recurrent shoulder joint dislocations. All patients had an extra-articular osteotomy with subcapital derotation according to Weber's technique. In all, 46% of the patients underwent additional intra-articular reconstructions. After a mean follow-up of 4.6 years, redislocations (6%) were observed only when a singular derotation technique had been used. Complications were minor (2.4%). External rotation of the operated shoulder joints was normal in most patients with a mean of 48.5 degrees. Improvement in sporting activities was seen in 80% and in working activities in 70%. The mean Constantscore was 89.2. Subacromial pain was rare and correlated with reduced scores in functional strain tests postoperatively. There was no postoperative arthritis owing to the derotation technique. Because of unrestricted rotation and early functional therapy, we observed a good indication for an additional derotation technique when a Hill-Sachs defect is evident.

Adolescent↗

[A case of neglected shoulder anterior dislocation with preservation of joint function].

Shoulder neglected anterior dislocation is a rare event and intolerated in young patients. We report a case of shoulder antero-medial dislocation among 15 years. It was a woman aged 35, who had a left shoulder trauma with an unnoticed antero-medial dislocation. Fifteen years later, the patient presented an inesthetic deformity with presevating function. The Rowe and Zarsins score was good. The radiographs showed the humeral neack in a neo-cavity of the joint associated to Malgaine lesion with an advanced arthrosis of the joint.

Adult↗

[Locked posterior dislocation of the shoulder].

Whereas anterior dislocation of the shoulder is very common, posterior dislocation occurs in less than 2% of all cases. The diagnosis of posterior shoulder dislocation - especially in locked position - is difficult. The exact knowledge of the position of the humeral head within the shoulder joint is extremely significant, as the following case shows. The posterior shoulder dislocation was primarily recognized and treated correctly, while radiographics after reduction were misinterpreted. In this paper diagnostic and therapeutic measures are described.

Adult↗

Immobilisation following traumatic anterior glenohumeral joint dislocation: a literature review.

Traumatic anterior dislocations of the shoulder are common and disabling injuries, in young and old alike. For centuries, the means of managing this injury has been to immobilise the affected shoulder after reduction, for up to 8 weeks, in an adducted and internally rotated position. The aim of this literature review is to assess whether traumatic anterior shoulder dislocations should be immobilised; for how long should they be immobilised; and whether the position of immobilisation affects outcomes. An electronic literature search was performed of the databases AMED, Cinahl, Embase, Medline (using Ovid), PEDro and Pubmed, from their inceptions to February 2005. Human clinical trials, written in English, which could assist in answering the research questions, were included. Sixteen (of 168) papers met the inclusion criteria and were reviewed. The review suggests that it remains unclear whether patients with traumatic primary anterior shoulder dislocations should be immobilised, or for how long. Similarly, it remains uncertain whether patients should be immobilised in internal, or external rotation. Much of this uncertainty is due to the limited size of the evidence base, which exhibited numerous methodological weaknesses (e.g. small sample sizes, no control groups, not evaluating findings against statistical tests). Recommendations are made to develop the evidence base.

Age Factors↗