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At least 1,243 records · Page 69Linked to original sources
PubMed1997

Recurrent anterior dislocation of the shoulder.

Results of recurrent anterior dislocation of the shoulder are reported. The procedures used were mainly Putti-Plat in 35 patients; Eden-Hybinette in five patients and Webers derotation osteotomy of the humerus in five patients. Recurrence rates in the 45 patients reviewed and followed up at three years post-operatively were: six in Putti-Plat and two in Eden-Hybinette and none in Webers osteotomy patients. Clinically, the functional post-operative results were "excellent" in 32 patients (71%), "satisfactory" in eight patients (18%); while they were "unsatisfactory" in three patients and "poor" in two patients. There were no appreciable differences depending on the operative method used. Radiologically, the Hill-Sachs defect on the posterolateral aspect of the humeral head was seen in 30 patients (67%) while Bankarts lesion of the glenoid rim osteoarthritis was seen in five patients (11%), while rotator cuff calcification was seen in nine patients (20%).

Adolescent↗
PubMedDate not supplied

The Hill-Sachs lesion. An experimental study.

The Hill-Sachs lesion is an important indication of previous anterior shoulder dislocation. We created Hill-Sachs lesions by using cadaveric humeri. Roentgenographs of these cadaveric humeri in the standard projections were then taken. Under fluoroscopy, new projections of the cadaveric humeri were obtained. In a clinical study, 15 patients (14 men and 1 woman; age range, 23 to 63 years; mean, 30 years) with known recurrent anterior shoulder dislocations were evaluated by using standard and new roentgenographic projections. On the basis of the cadaveric and clinical studies, the optimal methods for detecting Hill-Sachs lesions include the following three roentgenograms: anteroposterior view of the glenohumeral joint with the humerus in 45 degrees internal rotation, the notch (Stryker) view, and the modified Didiee view.

Adult↗
PubMed2000

Neglected traumatic posterior dislocations of the shoulder: controversies on indications for treatment and new CT scan findings.

We report seven missed traumatic posterior dislocations of the shoulder in six patients. In all seven shoulders, anteroposterior radiographs did not provide the diagnosis in the emergency room after the trauma (epileptic seizure in four patients) and diagnosis was delayed for at least 24 h. The final diagnosis was reached by clinical suspicion and computed tomography (CT) scan of the seven shoulders. Two shoulders were treated by closed reduction and three were treated by closed reduction and percutaneous pinning, although four of these five shoulders presented a defect in the humeral head involving 20%-25% of the articular surface. Two shoulders dislocated for more than 6 months were treated according to Mc Laughlin's technique modified by Hawkins instead of an arthroplasty. At a minimum follow-up of 2 years and 2 months, the functional results according to Hawkins were good in all seven shoulders. There was no recurrence of the dislocation in any patient. Radiographs showed mild degenerative changes. The establishment of indications for treatment, based on the proportion of articular surface of the humeral head involved and the time of evolution of the dislocation, needs more clinical or experimental evidence. In epileptic patients, strict control of medication is of the utmost importance.

Adult↗
PubMed2006

Simultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management. A case report.

We present the case of a patient who sustained simultaneous bilateral posterior dislocation of the shoulder after a possible epileptic fit. The confirmation of the diagnosis was reached only by a computed tomography (CT) scan, after the clinical suspicion. Under general anesthesia, close reduction of both shoulder dislocations was done. Posterior dislocation of the shoulder-especially the bilateral one-is very rare. When the history describes an electric shock or convulsive seizure, any shoulder injury demands a careful clinical and radiological evaluation. It is usually associated with reverse Hill-Sachs lesion (an impression defect of the anteromedial aspect of the humeral head), in which the size determines the treatment options.

Humans↗
PubMed2000

From Hippocrates to the Eskimo--a history of techniques used to reduce anterior dislocation of the shoulder.

It has been recognised for thousands of years that the shoulder joint is particularly prone to dislocation following trauma. From the time of Hippocrates, physicians have described a variety of different techniques aimed at reducing shoulder dislocations. In this article we review the historical development of these techniques and suggest that, despite being described as new, many of these are simply variations on an already established method.

History, 16th Century↗
PubMed2002

Upper extremity injuries in snowboarding and skiing: a comparative study.

OBJECTIVES: To determine the types and causes of upper extremity injuries sustained while snowboarding. DESIGN: A prospective survey of snowboarders with upper extremity injuries, especially fractures and dislocations. PARTICIPANTS: Between 1995 and 2000, we analyzed and interviewed 6,837 injured snowboarders and 2,175 injured skiers, and a total of 2,742 snowboarders and 361 skiers with fractures or dislocations of the upper extremities were studied. RESULTS: The ratio of upper extremity injuries to all injury types was significantly higher in snowboarders (40%, p < 0.001). Shoulder dislocations accounted for 5.5% of all injuries in skiers but 71% of all dislocations. In comparison, 6.5% of snowboarders' injuries were shoulder dislocations, representing 50% of all dislocations. It was noted that dislocation of the elbow joint was a more characteristic injury of snowboarders (30%) than of skiers (3%). The most frequently fractured site in skiers was the clavicle (32% of all fractures), and in snowboarders, it was the wrist (62% of all fractures). The most frequently affected side of the snowboarders' upper extremity was the left, with the exception of wrist fractures. With the exception of wrist fractures, the edge side that caused the accident was the opposite of the side that was injured. Most snowboarders did not have initial instruction from professional instructors (93%) and did not use protective equipment (87%). CONCLUSIONS: The results of this study indicate that the upper extremity injuries are much more common in snowboarders than skiers. In particular, upper extremity fractures in snowboarders are three times more common than in skiers. Furthermore, in snowboarding, wrist fractures have a different underlying cause compared with other upper extremity injuries.

Adolescent↗
PubMed1985

Non-union of a fractured coracoid process after dislocation of the shoulder. A case report.

A patient with a fractured coracoid process in association with a dislocation of the shoulder is reported. The fracture was not recognised initially, and early mobilisation was encouraged; the widely separated fracture did not heal and a painful pseudarthrosis developed. We believe that this association may not be as rare as generally supposed, and emphasise the importance of careful clinical examination in patients with shoulder dislocation. If a coracoid fracture is suspected, lateral or oblique radiographs should be taken to confirm the diagnosis. A further radiograph after reduction is a useful precaution.

Fractures, Ununited↗
PubMedDate not supplied

Pressure between the humeral head and the subscapularis tendon after the modified Boytchev procedure.

The pressure between the humeral head and the subscapularis tendon was determined in 32 patients who had recurrent anterior shoulder dislocations. These patients' pressures were measured during a modified Boytchev procedure both before and after transposition of the conjoined tendon, and they were remeasured at the time of screw removal, performed at a mean of 13 months after the initial surgery. The mean clinical follow-up period was 31 months. A micro-tip catheter transducer was inserted into the glenohumeral joint between the humeral head and the subscapularis tendon. Pressures were measured at particular degrees of motion for two positions: passive external rotation of the arm at the side at 0 degrees, 15 degrees, 30 degrees, 45 degrees, and 60 degrees and passive external rotation at the 90 degrees abducted position at 0 degrees, 30 degrees, 60 degrees, and 90 degrees. The pressures were statistically significantly higher after the conjoined tendon transfer at all measured degrees of motion in the two positions. The pressures at the time of screw removal were not statistically significantly different from those seen after the tendon transfer during external rotation at 90 degrees of abduction. The modified Boytchev procedure increases the pressure between the humeral head and the subscapularis tendon. We suspect that this increased pressure increases proprioceptive stimuli in the subscapularis tendon and thus accelerates the protective reflex needed to prevent shoulder dislocation.

Adolescent↗
PubMedDate not supplied

Loose body within the glenohumeral joint in recurrent anterior dislocation: CT demonstration.

A loose body within the glenohumeral joint in a patient with chronic anterior dislocation and recent trauma that prevented successful reduction of the dislocated shoulder was demonstrated by CT. Although the use of CT with arthrography has been reported in patients with recurrent dislocations and unstable shoulders, this is the first such reported demonstration using CT without contrast medium of a loose body preventing reduction.

Female↗
PubMed1994

Sonographic evaluation of posterior instability and dislocation of the shoulder: prospective study.

Owing to the exceptional mechanical precariousness of the glenohumeral joint, dislocations and instabilities are common. Because posterior dislocation or instability of the joint occurs infrequently, these abnormalities may be misdiagnosed on routine radiographic examinations in acute shoulder injuries. We present five patients in whom sonographic examination was used to diagnose posterior shoulder instability (three cases) and posterior shoulder dislocation (two cases). The sonographic technique demonstrates the presence of instability or dislocation and permits dynamic examination of the shoulder joint. Ultrasonography emerges as a useful and efficient novel technique for detecting these disorders. The accuracy, sensitivity, and specificity of the technique presented here are currently being determined.

Adult↗
PubMed1983

Posterior dislocation of the shoulder in athletes.

Although posterior dislocation of the shoulder is a rare injury in athletes, failure to recognize and properly manage acute dislocation may have serious consequences. The article discusses the incidence, mechanism of injury, classification, pathologic findings, clinical and radiologic diagnosis, and management.

Adolescent↗