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Shoulder instability conservative treatment

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https://www.readbyqxmd.com/read/29124296/-diagnostics-and-treatment-of-posterior-shoulder-instability
#1
REVIEW
M Wellmann, M-F Pastor, T Smith
Posterior shoulder instability has a markedly lower incidence than anterior shoulder instability. It has a wide spectrum of clinical symptom manifestations and the overwhelming number of patients lack a traumatic primary dislocation. In addition to a detailed medical history, a specific clinical examination with the help of standardized provocation tests is essential for the diagnostics. For the detection of structural posterior capsule and labral lesions in cases of chronic courses, magnetic resonance imaging (MRI) should be used with an intra-articular contrast agent...
November 9, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28979596/treatment-of-the-posterior-unstable-shoulder
#2
Eduardo Sánchez Alepuz, Jaime Alonso Pérez-Barquero, Nadia Jover Jorge, Francisco Lucas García, Vicente Carratalá Baixauli
BACKGROUND: It is estimated that approximately 5% of glenohumeral instabilities are posterior. There are a number of controversies regarding therapeutic approaches for these patients. METHODS: We analyse the main surgery alternatives for the treatment of the posterior shoulder instability. We did a research of the publications related with posterior glenohumeral instability. RESULTS: There are conservative and surgical treatment options. Conservative treatment has positive results in most patients, with around 65 to 80% of cases showing recurrent posterior dislocation...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979595/multidirectional-shoulder-instability-treatment
#3
Miguel Angel Ruiz Ibán, Jorge Díaz Heredia, Miguel García Navlet, Francisco Serrano, María Santos Oliete
BACKGROUND: The treatment of multidirectional instability of the shoulder is complex. The surgeon should have a clear understanding of the role of hiperlaxity, anatomical variations, muscle misbalance and possible traumatic incidents in each patient. METHODS: A review of the relevant literature was performed including indexed journals in English and Spanish. The review was focused in both surgical and conservative management of multidirectional shoulder instability...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28969823/editorial-commentary-leveraging-the-literature-what-can-a-half-century-s-worth-of-studies-tell-us-about-recurrent-instability-following-primary-shoulder-dislocation
#4
EDITORIAL
Mark P Cote
A benefit of systematic review (SR) research methods is that well-performed reviews allow authors and readers to identify weaknesses and variability in the orthopaedic literature. An SR on the topic of recurrence rates after conservative treatment of first-time shoulder dislocation provides an excellent example. The example reviews studies covering more than one-half century of time and employing varying methodological designs; the results include estimates of recurrence of shoulder dislocation ranging widely (from 4% to 94...
October 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28947382/the-effects-of-a-conservative-rehabilitation-program-for-multidirectional-instability-of-the-shoulder
#5
Lyn Watson, Simon Balster, Ross Lenssen, Greg Hoy, Tania Pizzari
BACKGROUND: Conservative management is commonly recommended as the first-line treatment for multidirectional instability (MDI) of the shoulder. Despite this, the evidence for efficacy of treatment is limited, and until recently, guidance for clinicians on conservative rehabilitation programs has been inadequate. This study evaluated the effectiveness of a physiotherapy-led exercise program for participants with MDI. METHODS: In a single-group study design, 43 participants (16 male, 27 female; mean age, 19...
September 22, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28888526/posterior-shoulder-instability-managed-by-arthroscopic-acromial-pediculated-bone-block-technique
#6
P Métais, J Grimberg, P Clavert, J-F Kouvalchouk, F Sirveaux, G Nourissat, J Garret, P Mansat, A Godenèche
In posterior shoulder instability (recurrent dislocation, involuntary posterior subluxation or voluntary subluxation that has become involuntary), surgery may be considered in case of failure of functional treatment if there are no psychological contraindications. Acromial bone-block with pediculated deltoid flap, as described by Kouvalchouk, is an alternative to iliac bone-block, enabling triple shoulder locking by the blocking effect, the retention hammock provided by the deltoid flap and posterior capsule repair...
September 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28868087/use-of-shoulder-pacemaker-for-treatment-of-functional-shoulder-instability-proof-of-concept
#7
Philipp Moroder, Marvin Minkus, Elisabeth Böhm, Victor Danzinger, Christian Gerhardt, Markus Scheibel
BACKGROUND: Functional shoulder instability (polar type III) is caused by underactivity of rotator cuff and periscapular muscles, which leads to subluxation or dislocation during shoulder movement. While surgical treatment has shown no benefits, aggravates pain, and frequently diminishes function even further, conservative treatment is often ineffective as well. OBJECTIVES: The aim was to investigate the effectiveness of a "shoulder pacemaker" device that stimulates underactive muscles in patients with functional instability during shoulder movement in order to re-establish glenohumeral stability...
2017: Obere Extremität
https://www.readbyqxmd.com/read/28861125/abc-classification-of-posterior-shoulder-instability
#8
REVIEW
Philipp Moroder, Markus Scheibel
Posterior glenohumeral instability (PGHI) is a commonly under- and misdiagnosed pathology owing to its variety of clinical presentations. In order to facilitate diagnosis and treatment, the simple yet comprehensive ABC classification for PGHI is based on the underlying pathomechanical principles and current standard of treatment. Three main groups of PGHI are distinguished based on the type of instability: A (first time), B (dynamic), C (static). Two subtypes further differentiate these groups in terms of their specific pathomechanism and provide a guideline in the choice of appropriate treatment: A (1, subluxation; 2, dislocation), B (1, functional; 2, structural), C (1, constitutional; 2, acquired)...
2017: Obere Extremität
https://www.readbyqxmd.com/read/28799049/-diagnostics-and-treatment-concepts-for-anteroinferior-shoulder-instability-current-trends
#9
F Martetschläger, M Tauber, P Habermeyer
Shoulder instability arises when static or dynamic stabilizers deviate from the natural equilibrium. The most common form of shoulder instability is in an anteroinferior direction, affects young athletes in contact sports and can lead to permanent impairment of shoulder function and early degeneration of the joint. Conservative as well as operative therapy options have been controversially discussed for years. This article describes the current state of diagnostics, current trends in therapy decisions and relevant therapy options for anterior shoulder instability...
October 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28777213/glenohumeral-instability-related-to-special-conditions-slap-tears-pan-labral-tears-and-multidirectional-instability
#10
Gregory S Van Blarcum, Steven J Svoboda
Glenohumeral instability is one of the more common conditions seen by sports medicine physicians, especially in young, active athletes. The associated anatomy of the glenohumeral joint (the shallow nature of the glenoid and the increased motion it allows) make the shoulder more prone to instability events as compared with other joints. Although traumatic dislocations or instability events associated with acute labral tears (ie, Bankart lesions) are well described in the literature, there exists other special shoulder conditions that are also associated with shoulder instability: superior labrum anterior/posterior (SLAP) tears, pan-labral tears, and multidirectional instability...
September 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28741077/-chronic-acromioclavicular-joint-injury-of-rockwood-v-type-with-concomitant-chronic-anterior-sternoclavicular-instability
#11
Sebastian Schmitt, Petra Magosch, Peter Habermeyer, Sven Lichtenberg
Bipolar dislocation of the clavicle is rare. In the literature, every reported bipolar dislocation of the clavicle is caused by a traumatic injury with loss of function of the affected shoulder. Currently, there is no recommendation to treat. A conservative treatment can be tried first to achieve adequate shoulder function. If this cannot be achieved, surgical treatment will be indicated. In the literature, many options for surgical treatment are described. This article presents a case of a chronic Rockwood V injury with chronic anterior sternoclavicular joint instability...
September 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28641736/a-comprehensive-rehabilitation-program-for-posterior-instability-of-the-shoulder
#12
Lyn Watson, Simon Balster, Sarah Ann Warby, Jackie Sadi, Greg Hoy, Tania Pizzari
Posterior shoulder instability is recognised as being less prevalent than anterior instability, however the diagnosis of this pathology is easily overlooked or missed and this may contribute to an underestimation of prevalence. Recently, there has been increasing recognition of this condition and consequently a greater requirement for knowledge of diagnostic procedures and treatment directions. Currently there is limited research into the conservative management of posterior instability, although it is recommended as first-line treatment prior to surgical review, particularly in those with an atraumatic instability mechanism...
April 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28630753/how-to-deal-with-a-glenoid-fracture
#13
Lars Henrik Frich, Morten Schultz Larsen
The glenoid fossa is involved in approximately 10% of all scapular fractures.Glenoid fossa incongruity is surprisingly well tolerated.Surgery is recommended when 20% or more of the anterior glenoid fossa is involved.Glenoid rim fractures often lead to chronic shoulder instability.Unstable glenoid neck fractures need surgical treatment and stable fractures can be treated conservatively.CT examination with 3D reformations of the glenoid fossa has improved insight into fracture morphology and fracture patterns and is very helpful for clinical decision makers...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28572850/the-treatment-of-multidirectional-instability-of-the-shoulder-with-a-rehabilitation-programme-part-2
#14
REVIEW
Lyn Watson, Sarah Warby, Simon Balster, Ross Lenssen, Tania Pizzari
BACKGROUND: The most commonly recommended initial treatment for multidirectional instability is a rehabilitation program. Although there is evidence to support the effect of conservative management on this condition, the published literature provides little information on the exercise parameters of such programs. METHODS: This paper is the second part of a two-part series that outlines a six-stage rehabilitation program for multidirectional instability with a focus on scapula control and exercise drills into functional positions...
January 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28461966/management-of-the-first-episode-of-traumatic-shoulder-dislocation
#15
REVIEW
Michele Boffano, Stefano Mortera, Raimondo Piana
Shoulder joint dislocation is the most common joint dislocation seen in the emergency department.Traumatic dislocation may cause damage to the soft-tissues surrounding the shoulder joint and sometimes to the bone. The treatment, which aims at restoration of a fully functioning, pain-free and stable shoulder, includes either conservative or surgical management preceded by closed reduction of the acute dislocation.Conservative management usually requires a period of rest, generally involving immobilisation of the arm in a sling, even though it is still debated whether to immobilise the shoulder in internal or external rotation...
February 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28361016/prevention-and-management-of-post-instability-glenohumeral-arthropathy
#16
REVIEW
Brian R Waterman, Kelly G Kilcoyne, Stephen A Parada, Josef K Eichinger
Post-instability arthropathy may commonly develop in high-risk patients with a history of recurrent glenohumeral instability, both with and without surgical stabilization. Classically related to anterior shoulder instability, the incidence and rates of arthritic progression may vary widely. Radiographic arthritic changes may be present in up to two-thirds of patients after primary Bankart repair and 30% after Latarjet procedure, with increasing rates associated with recurrent dislocation history, prominent implant position, non-anatomic reconstruction, and/or lateralized bone graft placement...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28149720/arthroscopically-assisted-acromioclavicular-and-coracoclavicular-ligament-reconstruction-for-chronic-acromioclavicular-joint-instability
#17
Frank Martetschläger, Mark Tauber, Peter Habermeyer, Nael Hawi
Acromioclavicular (AC) joint injuries are common injuries, especially in the young and active, male population. AC joint injuries account for 12% of all injuries of the shoulder girdle in the overall population. Although conservative treatment is recommended for Rockwood type I and type II injuries, there is controversial debate about optimal treatment for type III injuries. High-grade injuries are typically treated operatively to avoid painful sequelae. A vast number of different surgical methods have been described over the past few decades...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28098055/nonsurgical-treatment-of-mason-type-ii-radial-head-fractures-in-athletes-a-retrospective-study
#18
COMPARATIVE STUDY
M Guzzini, A Vadalà, A Agrò, V Di Sanzo, D Pironi, A Redler, P Serlorenzi, L Proietti, C Civitenga, D Mazza, R M Lanzetti, Andrea Ferretti
OBJECTIVE: The best treatment for moderately displaced radial head fractures (Mason type II) still remains controversial. In cases of isolated fractures, there is no evidence that a fragment displacement of ≥ 2 mm gives poor results in conservatively treated fractures. PATIENTS AND METHODS: We retrospectively reviewed 52 patients (31M, 21F) affected by an isolated Mason type II fracture, treated with a long arm cast for two weeks between 2008 and 2013. All patients had practiced sports before being injured...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#19
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
February 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/27697889/posterior-shoulder-instability
#20
REVIEW
Ivan J Antosh, John M Tokish, Brett D Owens
CONTEXT: Posterior shoulder instability has become more frequently recognized and treated as a unique subset of shoulder instability, especially in the military. Posterior shoulder pathology may be more difficult to accurately diagnose than its anterior counterpart, and commonly, patients present with complaints of pain rather than instability. "Posterior instability" may encompass both dislocation and subluxation, and the most common presentation is recurrent posterior subluxation. Arthroscopic and open treatment techniques have improved as understanding of posterior shoulder instability has evolved...
November 2016: Sports Health
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