Recurrent Anterior Dislocation of the Shoulder Ii. A Comparative Study

McLaughlin, Harrison L.; MacLellan, Donald

doi:10.1097/00005373-196703000-00002

Cited by 210 publications

(99 citation statements)

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“…Recurrence can range from 60% to 94% [2,[12][13][14]22,33] after the initial episode for patients less than 21 years of age and from 10% to 14% [21,33] for patients over the age of 40 years. Postoperatively, patients may suffer from persistent pain, stiffness, symptoms of instability and may require further surgery.…”

Section: Introductionmentioning

confidence: 99%

Multidirectional kinematics of the glenohumeral joint during simulated simple translation tests: Impact on clinical diagnoses

Moore

Musahl

McMahon

et al. 2004

Journal Orthopaedic Research

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At the end ranges of motion, the glenohumeral capsule limits translation of the humeral head in multiple directions. Since the 6-degree of freedom kinematics of clinical tests are commonly utilized to diagnose shoulder injuries, the objective of this study was to determine the magnitude and repeatability of glenohumeral joint kinematics during a simulated simple anteroposterior translation test in the anterior and posterior directions. A magnetic tracking system was used to determine the kinematics of the humerus with respect to the scapula in eight cadaveric shoulders. At 60" of glenohumeral abduction and 0" of flexionkxtension, a clinician applied anterior and posterior loads to the humerus at O", 30", and 60" of external rotation until a manual maximum (simulating a simple translation test) was achieved. Prior to each test, the reference position of the humerus shifted posteriorly 1.8 k 2.0 and 4.1 ? 3.8 mm at 30" and 60" of external rotation, respectively. Anterior translation decreased significantly (p < 0 05) from 18.2 t 5.3 mm at 0" of external rotation to 15.5 f 5.1 and 9.9k 5.5 mm at 30" and 60", respectively. However, no significant differences were detected between the posterior translations of 13.4f6.4, 17.1 2 5.0, and 15.8 k6.0 mm at O", 30", and 60" of external rotation, respectively.Coupled translations (perpendicular to the direction of loading) at 0" (6.1 k 4.0 and 3.8 ? 2.9 mm), 30" (4.7 t 2.7 and 5.9 k 3.1 mm), and 60" (2.3 2 2.3 and 5.0 k 3.5 mm) of external rotation were in the inferior direction in both the anterior and posterior directions, respectively. Based on the data obtained, performing a simulated simple translation test should result in coupled inferior translations and anterior translations that are a function of external rotation. The low standard deviations demonstrate that the observed translations should be repeatable. Furthermore, capsular stretching or injury to the anterior-inferior region of the capsule should be detectable during clinical examination if excessive coupled translations exist or no posterior shift of the reference position with external rotation is noted.

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Section: Introductionmentioning

confidence: 99%

Multidirectional kinematics of the glenohumeral joint during simulated simple translation tests: Impact on clinical diagnoses

Moore

Musahl

McMahon

et al. 2004

Journal Orthopaedic Research

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“…In all the patients, although they were immobilized for a sufficient time following their index dislocation, the dislocation recurred which is in comparable with the study that the initial mode of treatment and duration of immobilization does not alter the recurrence rate. 19,20,26,30 In 16 out of 19 shoulders, Hill Sachs lesion-mild defect in the posterolateral aspect of humeral head was found in the Stryker Notch view i. e. in 84.21% of the shoulder had mild Hill Sachs lesion [33] . In our series on clinical examination in all the patients apprehension sign was negative and in all the patients, the shoulder flexion, abduction and internal rotation were full.…”

Section: Discussionmentioning

confidence: 98%

“…There was uniform restriction of the external rotation-terminal 5 to 20 degrees of external rotation is restricted (average 12.5 degrees) in 5 patients there is restriction of terminal 15 degrees of extern rotation. The patients were unware of this as they had rarely experienced any difficulty with this restriction [30][31][32][33][34][35][36][37][38][39][40][41][42] . In follow-up, it was found in all the patients the transferred coracoids graft is well united and none had screw loosening.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Bristow-Later jet procedure in the treatment of recurrent traumatic anterior dislocation of shoulder

Karunakaran¹,

Rajamani²

2018

Int. J. Orthop. Sci.

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The shoulder by virtue of its anatomy and biomechanics is one of the most unstable and frequently dislocated joints in the body, accounting for nearly 50% of all dislocations. Since the beginning of century more than 150 surgical procedures were described in treating recurrent dislocation of the shoulder with varying results and success. Most of the operative techniques described for the treatment of recurrent anterior dislocation or subluxation of the shoulder have 2 distinct disadvantages; need to immobilize the shoulder for several weeks and Loss of external rotation. These can be overcome by Bristow-Laterjet procedure. We analysed Bristow-Laterjet procedure in the treatment of recurrent traumatic anterior dislocation of shoulder at the Department of Orthopaedics, Chengalpattu Medical College Hospital, Chengalpattu, Tamilnadu, India. We came across 20 patients (1 patient had bilateral dislocation) during February 2015 to February 2017. All the patients were followed up periodically both clinically and radiologically till their shoulder regained full range of movements and radiological bony union of the coracoid graft. All the patients were thoroughly examined and evaluated subjectively and objectively and outcome was assessed by Rowe's scoring system. We found all the patients were satisfied with surgery and were able to return to their pre dislocation level activity and none had further episodes of shoulder instability. Radiologically there was good bony union of the coracoid graft and there was no screw loosening.

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“…The incidence of recurrent dislocation ranges from 17-96% with a mean of 67% in patient populations between the ages of 21-30 years old. 1,[5][6][7][8][9][10][11][12][13][14][15] Therefore, the rehabilitation program should progress cautiously in young athletic individuals. It should be noted that Hovelius et al 8,16,17 has demonstrated that the rate of recurrent dislocations is based on the patient's age and not affected by the length of post-injury immobilization.…”

Section: Frequency Of Dislocationmentioning

confidence: 99%

Nonoperative rehabilitation for traumatic and atraumatic glenohumeral instability

Wilk

Macrina²,

Reinold³

2012

Shoulder Instability: A Comprehensive Approach

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Recurrent Anterior Dislocation of the Shoulder Ii. A Comparative Study

Cited by 210 publications

References 0 publications

Multidirectional kinematics of the glenohumeral joint during simulated simple translation tests: Impact on clinical diagnoses

Multidirectional kinematics of the glenohumeral joint during simulated simple translation tests: Impact on clinical diagnoses

Analysis of Bristow-Later jet procedure in the treatment of recurrent traumatic anterior dislocation of shoulder

Nonoperative rehabilitation for traumatic and atraumatic glenohumeral instability

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