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PubMedDate not supplied

Bankart-Delitala surgery in the treatment of recurrent anterior dislocation of the shoulder.

The study analyzes the results obtained when Bankart-Delitala surgery was used to treat recurrent anterior dislocation of the shoulder. A group of 30 patients were submitted to clinical and functional follow-up based on the Rowe system; 15 of the patients also underwent isokinetic testing. The data obtained were interpreted based on the Rowe system, but also analytically and statistically. The authors conclude that Bankart-Delitala surgery constitutes an effective surgical option in the treatment of recurrent anterior dislocation of the shoulder.

Evaluation Studies as Topic↗
PubMed1980

[Recurrent dislocation of the shoulder].

The article describes rich experience in the surgical treatment of the habitual dislocation in the shoulder joint. The method is based on the anatomo-physiological grounds consisting in the repair of the capsule ligament and elimination of the provocating influence of the subcapsular muscle which had lost its elasticity because of injuries in each dislocation. Operations, when correctly fulfilled, result in favourable outcomes in 94--95% of cases.

Adult↗
PubMed2001

[Analysis of synovial membrane apoptosis in different arthropathy].

OBJECTIVE: To study the relationship between synovial membrane apoptosis and different arthropathy for the pathogenesis of cartilage lesion in arthropathy. METHODS: Synovial specimens (28 cases) were divided into control group (9 cases), osteoarthritis group (7 cases), dislocation group (5 cases), meniscus injury group (5 cases) and arthropyosis group (2 cases). Synovial histological sections were stained with methylene blue, and examined under microscope. DNA was extracted from synovial specimens, and analysed by gel electrophoresis. RESULTS: DNA ladder pattern was the most clear in the arthropyosis group, moderately clear in the dislocation group (especially in a case of 20 years-old shoulder dislocation), less clear in the osteoarthritis group, the least clear in the meniscus injury group, and was not seen in the control group. CONCLUSION: It can be concluded that the increased apoptosis is related to causes, course and seriously of arthropathy, and it might be a pathogenesis of cartilage lesion in arthropathy.

Adolescent↗
PubMed1985

Haemarthrosis aspiration in treatment of anterior dislocation of the shoulder.

The beneficial effect of haemarthrosis aspiration in 13 women and one man aged over 60 years following anterior dislocation of the shoulder was compared with non-aspiration in a similar group of patients matched for age and sex. The results showed a consistent reduction in pain, early increased range of movement and earlier return of functional activity in the aspirated group. It is proposed that this simple therapeutic procedure be used to aid rehabilitation in the over-60 age group following anterior dislocation of the shoulder.

Aged↗
PubMed1992

Rotator cuff tears in anterior dislocation of the shoulder.

We diagnosed 16 rotator cuff tears in 109 shoulders in 104 patients with a traumatic anterior dislocation. Twelve of these were followed up for an average of 32 months. A surgical repair of the cuff was carried out in eleven and the results were satisfactory in eight (73%) regardless of a Bankart lesion. The repair of a torn cuff seems to be sufficient to stabilise the shoulder in elderly patients, even when a Bankart lesion is present and is not repaired.

Aged↗
PubMed1997

Recurrent traumatic anterior dislocation of the shoulder. 218 consecutive cases treated by a modified Magnuson-Stack procedure and follow for 2-18 years.

Over a period of 30 years (1961-1991), 218 patients with recurrent anterior dislocation of the shoulder were operated on at the Naval Hospital of Greece using a modified Magnuson-Stack method. The modification involved transfer of the subscapularis tendon not only laterally to the bicipital groove, but also 1 cm distally (Karadimas et al. 1980). 210 patients (213 shoulders) were examined after a follow-up of 9 (2-18) years. Results were evaluated according to pain, limitation of motion, muscular power and atrophy. 183 patients (87%) had very good results, 21 cases (10%) had good results, while 6 cases (3%) had fair results. Only 3 recurrences (1%) were recorded.

Adolescent↗
PubMed1994

[Limbus diagnosis by computerized tomography after initial traumatologic dislocation of the shoulder].

This paper shows a retrospective analysis of 98 shoulder joint CT scans after traumatic primary anterior dislocation in the period of 1988 till December 1991. The intraoperative findings and the X-ray characteristics beside arthrographic and MRI examinations led us to a classification of four types by pathomorphologic aspects, the type of the tear correlated to the degree of instability. For anterior limbus tear and lesions, a CT scan gives a diagnostic sensitivity of more than 90% (own rate 94.6%). Concerning our patients, the total lesions rate of 77.6% following first traumatic dislocation justifies a progressive examination and evaluation of the joint structures, that enhance further dislocations. Hereby, inspite of its invasivity, joint CT scan have, in comparison to other diagnostic procedures, proved to be routinely useful.

Adult↗
PubMed2001

[Recurrent luxations after arthroscopic refixation of the labrum using suture anchors in traumatic ventral shoulder luxation].

OBJECTIVE: Recurrence rates after arthroscopic labral reconstruction for anterior shoulder instability are still higher than after open procedures. Therefore, proper selection of patients becomes increasingly important. The aim of this study was to investigate factors influencing recurrence rates after arthroscopic labral repair with suture anchors. PATIENTS AND METHODS: We examined 53 patients (43 male, 10 female) with traumatic anterior shoulder dislocations, who were treated with arthroscopic labral repair using Fastak-Suture anchors between 1995 and 1996. The average follow-up time was 18 (12-30) months. The mean age of the patients at the time of operation was 27 (15-44) years. RESULTS: Postoperatively, 11 patients (20.7%) reported on redislocations. Recurrence rates increased significantly in patients with more than 4 preoperative dislocations and in patients with bony Bankart lesions. In patients without redislocations, the mean Rowe score improved from 65.9 (SD +/- 12.3) preoperatively to 88.6 (SD +/- 12.5) at follow-up. Thus, there were 24 excellent, 9 good and 6 fair results, while in 3 patients with persisting signs of shoulder instability results had to be estimated as poor. Deficits in the range of motion of more than 15 degrees were seen in 7 patients with predominant affection of the external rotation. CONCLUSION: Frequent preoperative dislocations and bony Bankart lesions contribute substantially to high recurrence rates after arthroscopic labral repair. Therefore, in these cases open procedures should be preferred.

Adolescent↗
PubMed1987

The Magnuson-Stack operation for recurrent anterior dislocation of the shoulder. A review of 38 cases.

The modified Magnuson-Stack procedure of lateral and distal transfer of the insertion of the subscapularis muscle was used in 38 consecutive patients with recurrent anterior dislocation of the shoulder, all of whom have been followed-up for a minimum of three years. There was only one failure; the other 37 patients had an excellent or satisfactory result with an adequate range of movement. Bankart and Hill-Sachs lesions were not a constant finding but subscapularis laxity was detected in almost every case, an observation that helps to confirm its central role as a cause of recurrence.

Adolescent↗
PubMed2005

[Anterior dislocation of the shoulder--a reduction technique that is easy on the patient].

Modified scapula manipulation represents a simple, highly successful and--both for the physician and the patient--pleasant new reduction technique in cases of anterior dislocation of the shoulder. The advantages of this technique--in particular in comparison with the previously employed methods are well founded. Non-evaluated methods, which are fraught with complications, such as the Hippocrates' method, should no longer be applied.

Adolescent↗
PubMed1979

Injury to the suprascapular nerve associated with anterior dislocation of the shoulder: case report and review of the literature.

A young man with persistent pain beginning 2 days following reduction of an anterior subcoracoid dislocation was found to have a suprascapular nerve injury. The patient described was felt to have a neurapraxia of the suprascapular nerve. Possible causes of post-reduction subluxation are interposition of the shoulder joint capsule or biceps tendon, or rupture of the rotator cuff. EMG in 3 weeks, followup examinations, and active assisted motion 4 to 6 weeks postinjury are recommended.

Adult↗
PubMed1996

Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study.

Two hundred and forty-five patients who had had 247 primary anterior dislocations of the shoulder were followed for ten years in a multicenter study at twenty-seven Swedish hospitals. The ages of the patients at the time of the dislocation ranged from twelve to forty years. The patients were assigned to one of three treatment groups: immobilization with the arm tied with a bandage to the torso for three to four weeks after reduction of the dislocation; use of a sling, which was discontinued after the patient was comfortable; or immobilization for various durations. At the ten-year follow-up evaluation, no additional dislocation had occurred in 129 shoulders (52 per cent). Recurrent dislocation necessitating operative treatment had developed in fifty-eight shoulders (23 per cent): thirty-four (34 per cent) of the ninety-nine shoulders in patients who were twelve to twenty-two years old, sixteen (28 per cent) of the fifty-seven shoulders in patients who were twenty-three to twenty-nine years old, and eight (9 per cent) of the ninety-one shoulders in patients who were thirty to forty years old. Twenty-four (22 per cent) of the shoulders that had had at least two recurrences during the first two or five years seemed to have stabilized spontaneously without operative intervention at ten years. Dislocation of the contralateral shoulder occurred in association with sixteen (16 per cent) of the ninety-nine shoulders in patients who were twelve to twenty-two years old, twelve (21 per cent) of the fifty-seven shoulders in patients who were twenty-three to twenty-nine years old, and only three (3 per cent) of the ninety-one shoulders in patients who were thirty to forty years old. The type and duration of the initial treatment had no effect on the rate of recurrence. Radiographs, made for 185 shoulders at the time of the primary dislocation, demonstrated an evident Hermodsson (Hill-Sachs) lesion in ninety-nine shoulders (54 per cent); this finding was associated with a significantly worse prognosis with regard to recurrence than was no evident lesion (p < 0.04). Radiographs made for 208 shoulders at the ten-year follow-up examination were evaluated for post-dislocation arthropathy. Twenty-three shoulders (11 per cent) had mild arthropathy and eighteen (9 per cent) had moderate or severe arthropathy. Some of the shoulders that had arthropathy had had no recurrence.

Adolescent↗
PubMed2001

[Chronic instability and fixed dislocation of the shoulder].

Chronic instabilities may be traumatic or atraumatic, unidirectional or multidirectional. It is important to distinguish between symptomatic instability and asymptomatic hyperlaxity. Posttraumatic, unidirectional anterior instability without hyperlaxity is the most common form of instability. The patient presents apprehension, the sulcus-sign is negative. Posttraumatic, unidirectional instability with hyperlaxity is due to an adequate trauma, both the apprehension test and the sulcus sign are positive. The treatment of traumatic instability is surgically with respect to the underlying pathology of the ligaments, labrum and capsule. The "golden standard" is the reconstruction of the capsulolabral complex. The repetitive microtraumatic instability is seen in overhead athletes with elongation or disruption of the capsule. The typical patient presents with painful subluxations, the instability may be unidirectional or multidirectional. The treatment is conservatively. Multidirectional instability with hyperlaxity is defined as symptomatic instability in at least two directions of instability with multidimensional hyperlaxity. These individuals will also report on pain rather than instability. The apprehension test is positive in at least two directions, the sulcus sign is positive as well. The patients are responsive to an intensive rehabilitation program for 6-12 months. Open capsular shift or thermal capsular shrinkage may be successful after failed conservative treatment. Multidirectional instability without hyperlaxity is extremely rare and is due to more than one adequate trauma with traumatic instability in different directions. The apprehension test is positive, the sulcus sign negative. The treatment is surgically. The fixed dislocation is posterior in most of the cases and frequently being missed primarily. It is seen in unconscious, multiple-injured patients or after grand mal or electroshock seizures. The reduction may be either closed or open depending on the interval between trauma and diagnosis. Voluntary instability represents a subset of individuals with atraumatic instability. The patients can dislocate and reduce their shoulder, have no pain and do not develop arthritis. They do not require a special therapy.

Adult↗