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At least 1,261 records · Page 70Linked to original sources

A new method of immobilization after traumatic anterior dislocation of the shoulder: a preliminary study.

This preliminary prospective study was conducted to determine whether immobilization with the arm in external rotation would decrease the rate of recurrence after initial traumatic anterior dislocation of the shoulder. Forty patients with initial shoulder dislocations were assigned to (1) conventional immobilization in internal rotation (IR group, n = 20) or (2) a new method of immobilization in external rotation (ER group, n = 20). The recurrence rate was 30% in the IR group and 0% in the ER group at a mean 15.5 months. The difference in recurrence rate was even greater among those who were aged less than 30 years (45% in the IR group and 0% in the ER group). Immobilization with the arm in external rotation is effective in reducing the rate of recurrence after initial dislocation of the shoulder.

Adolescent↗

Anterior dislocation of the shoulder joint sustained through skiing. Arthrographic findings and prognosis.

Over a period of 10 years we have studied 14,952 cases of skiing injuries. Of these, 660 cases (4.5%) were injuries to the shoulder with 291 cases (44.1%) being anterior dislocations of the shoulder. One hundred forty-three cases revealed an initial dislocation (49.1%), and 148 cases were recurrent dislocations (50.9%). We examined the arthrography of the dislocated shoulder in 89 cases. Of these initial dislocations, one-half of the capsular detachment type were redislocated, but no redislocation had occurred in the capsular tear type. In addition, almost all of the recurrent cases were of the capsular detachment type. Thus, through arthrography of the anterior dislocated shoulder, we have been able to discover the mechanism of the dislocation and decide upon the necessary duration and method of fixation of the shoulder after reduction.

Adolescent↗

Two cases of Charcot's shoulder arthropathy.

Two cases of Charcot's arthropathy of the shoulder demonstrate that acute, as well as chronic, arthropathy may develop in patients with normal protective joint sensitivity. In one case the changes developed rapidly, and arthrodesis was performed with an excellent result. In the other, Charcot changes occurred in a patient with an untreated bilateral shoulder dislocation.

Adult↗

Sports injuries of the shoulder.

Much strain is placed on the shoulder joint in all sports. Sports injuries may be caused by a single, violent incident. Fractures of the clavicle, acromioclavicular and sternoclavicular traumas, isolated fractures of the greater tuberosity and shoulder dislocations are frequent clinical pictures which today can be managed by well established procedures. Other sports injuries, however, involve over-use of the shoulder which, through repetitive harmful movements, can bring about microtraumatic lesions of the rotator cuff, glenoid labrum, acromioclavicular joint and certain peripheral nerves around the suprascapularis. In all cases, a programmed, comparative, clinical examination and complementary, sequential examinations will indicate suitable curative and preventive treatment.

Acromioclavicular Joint↗

[Anterior dislocation of the shoulder caused by electric shock].

Dislocation of the shoulder caused by electric shock is extremely rare and is frequently diagnosed late in the course of the condition. Late diagnosis and treatment make reduction difficult and increase the risks of permanent injuries. A case of unilateral anterior dislocation of the shoulder after a shock of 380 volts is presented here. The dislocation was diagnosed immediately and both reduction and recovery were uneventful.

Adult↗

Posterior fracture dislocation of the shoulder with biceps tendon interposition.

Posterior dislocation of the shoulder, a rare injury, results from direct trauma, indirect trauma, or via a seizure or electrical shock. We present a case with a posterior fracture dislocation of the shoulder secondary to a seizure in which interposition of the biceps tendon precluded closed reduction. The fractured lesser tuberosity fragment included the bicipital groove, allowing the biceps tendon to sublux posteriorly preventing closed reduction, thus requiring a subsequent open reduction.

Humans↗

Locked posterior dislocation of the shoulder: treatment using rotational osteotomy of the humerus.

This study reports the use of rotational osteotomy in 10 patients with locked posterior dislocation of the shoulder. The average interval between injury and diagnosis was 155 days (range, 21-400 days). Patients were aged 40-78 years old, with an average age of 53 years. Articular impaction fracture of the humeral head involved 20-40% of the articular surface as determined by CT analysis. There were no postoperative complications except a transient axillary nerve palsy. Patients were started on immediate passive motion followed by an active program at 2-3 weeks. Using the Rowe/Zarins scale, six patients had good-excellent results, two fair results, and two poor results. The poor results were seen in cases where articular cartilage damage was advanced. Rotational osteotomy is an effective procedure at restoring glenohumeral congruity and early functional activity in the patient with locked posterior shoulder dislocation given the following criteria: (a) healthy articular cartilage, (b) a humeral head defect involving less than 40% of the articular surface, and (c) a patient who is able to participate in an active rehabilitation program.

Adult↗

Anterior fracture-dislocations of the shoulder: pitfalls in treatment.

Fracture-dislocations of the shoulder can present difficulties in treatment. Two cases are described to illustrate the complications that can occur when an inexperienced examiner attempts a closed reduction of a two-part anterior fracture-dislocation of the shoulder. Careful clinical and radiologic evaluation (A-P and transcapular or axillary lateral X-rays) followed by appropriate management can help to prevent these problems from occurring. If there is evidence that the fracture is displaced by manipulation, immediate open reduction and internal fixation are recommended.

Female↗

[Baumann shoulder reposition].

An untraumatic method for the reposition of dislocated shoulders without any analgesia is presented. That the way of this method must be right, is proved by a short historical view and by case reports; On one side by the inventor of this method and on the other side by a retrospective study from the orthopedic department of the Kantonsspital of St. Gallen. How to do this reposition is clearly described by words and pictures.

Adult↗

Unrecognized dislocations of the shoulder.

The missed anterior dislocation is not such a diagnostic trap given that the shoulder injury is brought to the attention of a physician. Any roentgenogram will determine the diagnosis and the appropriate treatment can be implemented. The presence of an associated cuff lesion may compromise the surgical results. Missed anterior dislocations may function slightly better overall than missed posterior dislocations.

Adult↗

Anterior dislocation of the shoulder in patients over 50 years of age.

Six patients over 50 years of age were treated and followed for traumatic, first-time anterior dislocation of the shoulder. Early post injury examination following the subsidence of acute pain due to the injury demonstrated passive motion that exceeded active motion. Later follow up, however, revealed that active motion was equal to passive motion. The author concludes that these patients injured their rotator cuffs at the time of the shoulder dislocation and that such rotator cuff injuries healed satisfactorily without surgical repair.

Aged↗

Double-contrast arthrotomography of the shoulder.

We have used double-contrast arthrotomography to assess the glenoid labrum, as plain radiographs and single-contrast arthrograms are unsatisfactory for this purpose. Establishing the clinical diagnosis of a torn glenoid labrum may be difficult, as not all patients with such tears have a history of a previous shoulder dislocation. The glenoid labrum is seen distinctly on double-contrast arthrotomography, and tears are manifested by truncation or blunting of the anteroinferior lip. We compared the anatomy of the normal shoulder as seen in double-contrast arthrotomography with that seen in patients with surgically proved tears of the glenoid labrum. Double-contrast arthrotomography is an accurate method of assessing the integrity of the glenoid labrum, and it has important implications for the operative management of patients with trauma to the shoulder.

Humans↗