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[Arthroscopy of post-traumatic shoulder pain].

Thirty-two consecutive patients suffering chronic shoulder pain for more than six months after a non-dislocating shoulder trauma were examined clinically and with arthroscopy of the shoulder. The trauma was blunt or simple distortion of the shoulder. The patients complained of pain during loading, especially during over the head activities. Symptoms of dead arm and feeling of instability with a popping sensation inside the shoulder were also present. Patients with previous dislocations, trauma or radiographic signs of degenerative shoulder lesions were excluded. Clinically, 21 patients had decreased range of motion, 19 patients had a positive anterior apprehension sign and four of these had signs of shoulder instability. Nine patients had signs of impingement. The suspected preoperative diagnoses included a tear of the rotator cuff (17), a tear of the labrum (12), tendinitis of the biceps tendon (2) and periarthrosis of the shoulder (1). Arthroscopic findings consisted of 22 labral tears, six partial and three total rotator cuff lesions and three cases of synovitis of the rotator cuff with signs of subacromial impingement. Four patients had tendinitis of the biceps tendon. One patient had a lesion of the greater tubercle. Only two shoulders were found to be unstable under anaesthesia. In conclusion, patients with posttraumatic chronic shoulder pain after a non-dislocating trauma of the shoulder should be evaluated with arthroscopy in order to diagnose possible intraarticular lesions.

Adolescent↗

[Glenohumeral instability and arthrosis].

Although the development of arthrosis is rare following shoulder dislocations, it represents a significant problem if it develops after surgery for shoulder instability. The incidence of arthrosis may be decreased by correct diagnosis of the instability and appropriate surgical technique. However, should it occur, shoulder arthroplasty should be considered.

Arthroplasty↗

Electromyographic biofeedback use in the treatment of voluntary posterior dislocation of the shoulder: a case study.

Voluntary posterior dislocation of the shoulder has been difficult to treat successfully. Electromyographic biofeedback is a nonoperative treatment measure that has been successfully used for this condition in three previously reported cases. The purpose of this article is to present a case history in which electromyographic biofeedback was used successfully as part of a nonoperative treatment program for voluntary posterior dislocation of the shoulder.

Adolescent↗

Recurrent dislocation of the shoulder and the Putti Platt operation.

Recurrent dislocation of the shoulder has long been recognized, and more than 100 techniques for repair of the injury are described. This survey describes 113 patients who suffered from recurrent anterior dislocation of the shoulder and were operated upon in accordance with the Putti Platt technique. The most significant preoperative finding was inadequate immobilization after the primary dislocation (62% of the patients). Postoperative recurrence was uncommon (1%) and a relative increased limitation of motion in the postoperative period improved gradually to almost a full range of movement.

Adolescent↗

[Chronic dislocations of the shoulder].

Diagnosis and management of chronic dislocations of the glenohumeral joint remain challenging. These dislocations usually occur in debilitated patients with a poor bone quality and they often have a decreased rehabilitation potential. Treatment can only be successful with early recognition of the condition, careful patient selection, and implementation of appropriate surgical techniques. This article reviews current information on clinical evaluation, preoperative radiologic investigations, and treatment strategies in patients with chronic dislocations of the glenohumeral joint and associated articular surface defects.

Chronic Disease↗

Bilateral posterior pendulum dislocation of the shoulder. Case report and review of the literature.

A 20-year-old patient with bilateral voluntary and involuntary dislocation of both shoulders is reported on. There was no history of significant trauma, no systemic hypermobility of joints, no signs of neurological or psychological problems, and no evidence of joint disease. According to Reischauer's classification of shoulder instabilities, the patient suffered from bilateral posterior pendulum dislocations of his shoulders. The literature is reviewed and different classifications of shoulder instability and the underlying pathology of voluntary and involuntary shoulder dislocations are discussed. After ruling out the possibility of psychological problems, we performed an operative stabilization by arthroscopic means. At 1-year follow-up the patient reported no recurrence, good shoulder musculature, and no disability at work. This result confirms the unsuspicious psychological evaluation and our therapeutic management.

Adult↗

Dislocation of the shoulder with ipsilateral humeral shaft fracture.

A case of dislocation of the shoulder and ipsilateral fracture of the shaft of the humerus is reported. The mechanism of this injury is detailed. The use of the limb lengthening apparatus as an external fixator, which rendered the management of this combination injury easy, is described. The literature on this subject is reviewed.

Adult↗

[The radiographic diagnosis of posterior dislocation of the shoulder (author's transl)].

In spite of its clinical features, the diagnosis of posterior dislocation of the shoulder is often missed. The authors considered that this is due to an inadequate analysis of the x-rays. They show that the diagnosis can be made on an antero-posterior x-ray and describe the findings in fourteen cases. They note a modification of the gleno-humera line and the features of the associated impaction fracture. A lateral view is necessary to make the diagnosis certain, an axillary view being preferred to a trans-thoracic late-femoral head or of the posterior glenoid margin.

Humans↗

[Latarjet's surgery in recurrent anterior dislocations of the shoulder. 117 cases with an 8-year follow-up].

One hundred and seventeen shoulders in 113 patients were treated surgically for recurrent anterior dislocation of the shoulder by the Latarjet procedure - transplantation of the coracoid process to the anterior border of the glenoid fossa. 67 p. 100 of the patients engaged in sport and 33 p. 100 did not. The usual lesions found at operation were separation of the capsule from the anterior rim of the glenoid in 59 p. 100, a lesion of the glenoid labrum in 65 p. 100 and damage to the glenoid fossa short of a fracture in 18 p. 100. Postoperative complications were rare and usually mild, except in two cases of osteoporosis of the coracoid transplant and two fractures of the bone block. There was slight limitation of lateral rotation in 48 p. 100, of abduction in 14 p. 100 and of medial rotation in 4 p. 100. The results at follow-up were rated as excellent in 68 p. 100 (72 cases), good in 21.7 p. 100 (23 cases), with slight pain and limitation of lateral rotation of less than 20 p. 100 and fair in 6.6 p. 100 (7 cases). In these cases, the Latarjet procedure had been performed for postoperative recurrence after a previous surgical procedure. There were 4 poor results.

Adult↗