Acute Shoulder Injury

Cibulas, Andrew; Leyva, Alexander; Cibulas, George A.; Foss, Michael; Boron, Agnieszka; Dennison, John V; Gutterman, Brett; Kani, Kimia Khalatbari; Porrino, Jack; Bancroft, Laura W.; Scherer, Kurt

doi:10.1016/j.rcl.2019.03.004

Cited by 23 publications

(17 citation statements)

References 26 publications

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“…In these cases, the glenohumeral articular surface is preserved rather than dislocated, as seen with the classic four-part proximal humerus fracture. An intact medial calcar carries a lower risk of post-traumatic avascular necrosis and may be treated without surgery [14] , [15] . Therefore, this potentially management-altering distinction should be noted by the radiologist.…”

Section: Proximal Humerus Fracturementioning

confidence: 99%

“…Treatment of two- and three-part fractures can vary depending on the fracture complexity and patient comorbidities. Patients with four-part fractures often have surgery to minimize the risk of avascular necrosis, chronic pain, and disability [2] , [15] , [18] . Surgical options for proximal humeral fractures include plate and screw fixation, intramedullary nailing, or tension band constructs.…”

Section: Proximal Humerus Fracturementioning

confidence: 99%

“…Posterior shoulder dislocations occur when the humeral head is forced posteriorly, often seen with direct anterior trauma or seizures [7] , [15] . The posteroinferior glenoid head may be involved, resulting in a reverse bony Bankart lesion, and the impression at the anteromedial aspect of the humeral head, a reverse Hill-Sachs lesion ( Fig.…”

Section: Glenohumeral Dislocationmentioning

confidence: 99%

“…14 ) [33] . Recurrent glenohumeral joint instability is likely if the glenoid bone loss is > 7 mm in width or > 20–30% of the total glenoid surface area [15] , [29] .

Fig.…”

Section: Glenohumeral Dislocationmentioning

confidence: 99%

“…The majority of RCTs are degenerative. Repetitive motion leads to tendinosis, then gradual thinning and eventually tearing, often with impingement as an accelerating risk factor [15] . Traumatic RCTs are less common and occur in young and middle-aged men from sudden acceleration-deceleration and rotational forces applied through the arm to the shoulder, most often related to motor vehicle collision or sports injuries [47] .…”

Section: Traumatic Rotator Cuff Tearsmentioning

confidence: 99%

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Imaging of traumatic shoulder injuries – Understanding the surgeon’s perspective

Bao

DeAngelis

2022

European Journal of Radiology Open

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Section: Proximal Humerus Fracturementioning

confidence: 99%

Section: Proximal Humerus Fracturementioning

confidence: 99%

Section: Glenohumeral Dislocationmentioning

confidence: 99%

“…14 ) [33] . Recurrent glenohumeral joint instability is likely if the glenoid bone loss is > 7 mm in width or > 20–30% of the total glenoid surface area [15] , [29] .

Fig.…”

Section: Glenohumeral Dislocationmentioning

confidence: 99%

Section: Traumatic Rotator Cuff Tearsmentioning

confidence: 99%

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Imaging of traumatic shoulder injuries – Understanding the surgeon’s perspective

Bao

DeAngelis

2022

European Journal of Radiology Open

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Recurrence in traumatic anterior shoulder dislocations increases the prevalence of Hill–Sachs and Bankart lesions: a systematic review and meta-analysis

Rutgers

Verweij²,

Priester-Vink³

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The extent of shoulder instability and the indication for surgery may be determined by the prevalence or size of associated lesions. However, a varying prevalence is reported and the actual values are therefore unclear. In addition, it is unclear whether these lesions are present after the first dislocation and whether or not these lesions increase in size after recurrence. The aim of this systematic review was (1) to determine the prevalence of lesions associated with traumatic anterior shoulder dislocations, (2) to determine if the prevalence is higher following recurrent dislocations compared to first-time dislocations and (3) to determine if the prevalence is higher following complete dislocations compared to subluxations. Methods PubMed, EMBASE, Cochrane and Web of Science were searched. Studies examining shoulders after traumatic anterior dislocations during arthroscopy or with MRI/MRA or CT published after 1999 were included. A total of 22 studies (1920 shoulders) were included. Results The proportion of Hill–Sachs and Bankart lesions was higher in recurrent dislocations (85%; 66%) compared to first-time dislocations (71%; 59%) and this was statistically significant (P < 0.01; P = 0.05). No significant difference between recurrent and first-time dislocations was observed for SLAP lesions, rotator-cuff tears, bony Bankart lesions, HAGL lesions and ALPSA lesions. The proportion of Hill–Sachs lesions was significantly higher in complete dislocations (82%) compared to subluxations (54%; P < 0.01). Conclusion Higher proportions of Hill–Sachs and Bankart were observed in recurrent dislocations compared to first-time dislocations. No difference was observed for bony Bankart, HAGL, SLAP, rotator-cuff tear and ALPSA. Especially when a Hill–Sachs or Bankart is present after first-time dislocation, early surgical stabilization may need to be considered as other lesions may not be expected after recurrence and to limit lesion growth. However, results should be interpreted with caution due to substantial heterogeneity and large variance. Level of evidence IV.

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