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Shoulder instability conservative treatment

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https://www.readbyqxmd.com/read/28641736/a-comprehensive-rehabilitation-program-for-posterior-instability-of-the-shoulder
#1
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
#2
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
#3
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
#4
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 Rev
https://www.readbyqxmd.com/read/28361016/prevention-and-management-of-post-instability-glenohumeral-arthropathy
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27665529/evidence-based-conservative-rehabilitation-for-posterior-glenohumeral-instability-a-systematic-review
#10
REVIEW
Kelli McIntyre, Annie Bélanger, Jasdeep Dhir, Lyndsay Somerville, Lyn Watson, Myles Willis, Jackie Sadi
STUDY DESIGN: Systematic review. OBJECTIVES: To identify the best evidenced-based approach for the conservative rehabilitation of patients with posterior glenohumeral instability. BACKGROUND: Posterior glenohumeral instability is more common than previously thought. Proper management is imperative to control symptoms and maximize function. METHODS: We conducted an electronic search, up to November 2014, for English-language studies involving rehabilitation of posterior shoulder instability...
November 2016: Physical Therapy in Sport
https://www.readbyqxmd.com/read/27660660/the-treatment-of-multidirectional-instability-of-the-shoulder-with-a-rehabilitation-program-part-1
#11
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. In addition, current published rehabilitation programs for multidirectional instability do not focus on scapula stability or exercise drills into functional and sports-specific positions, which are often important aspects to consider in this patient population...
October 2016: Shoulder & Elbow
https://www.readbyqxmd.com/read/27582989/physiotherapy-treatment-for-atraumatic-recurrent-shoulder-instability-early-results-of-a-specific-exercise-protocol-using-pathology-specific-outcome-measures
#12
Marcus Bateman, Benjamin E Smith, Sally E Osborne, Sally R Wilkes
BACKGROUND: Recurrent shoulder instability is usually caused by a traumatic event resulting in structural pathology, although a small subgroup of patients experience symptomatic recurrent shoulder instability without trauma. These patients are usually treated non-operatively but limited evidence exists regarding effective conservative management. In particular, there is a lack of reproducible exercise regimes and none that have been tested with condition-specific outcome measures. METHODS: A service evaluation was conducted over a 15-month period to assess our current treatment protocol used in the management of patients with atraumatic recurrent shoulder instability...
October 2015: Shoulder & Elbow
https://www.readbyqxmd.com/read/27525497/conservative-treatment-is-sufficient-for-acute-distal-radioulnar-joint-instability-with-distal-radius-fracture
#13
Sang Ki Lee, Kap Jung Kim, Yong Han Cha, Won Sik Choy
Treatments for acute distal radioulnar joint (DRUJ) instability with distal radius fracture vary from conservative to operative treatment, although it seems to be no consensus regarding which treatment is optimal. This prospective randomized study was designed to compare the clinical outcomes for operative and conservative treatment of acute DRUJ instability with distal radius fracture, according to the presence or absence and type of ulnar styloid process fracture and the degree of its displacement. Between July 2008 and February 2013, we enrolled 157 patients who exhibited an unstable DRUJ during intraoperative manual stress testing (via the ballottement test) after fixation of the distal radius...
September 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27501704/management-of-shoulder-instability-the-current-state-of-treatment-among-german-orthopaedic-surgeons
#14
Maurice Balke, Sven Shafizadeh, Bertil Bouillon, Marc Banerjee
INTRODUCTION: The aim of this study was to evaluate the current state of treatment in traumatic anterior shoulder dislocation in Germany and to detect changes over the last 12 years. METHODS: Seven hundred ninety-six trauma and/or orthopaedic departments were found in the German hospital directory 2012. The websites of each department were searched for the email address of the responsible shoulder surgeon (if applicable) or the head of the department. Seven hundred forty-six email addresses were found, and emails with the request to participate in an online survey were sent in January 2013...
December 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27491571/the-result-of-surgical-treatment-of-medial-epicondylitis-analysis-with-more-than-a-5-year-follow-up
#15
Soo-Hong Han, Jun-Ku Lee, Hyeong-Jong Kim, Soo-Hyun Lee, Ji-Woong Kim, Tae-Seob Kim
BACKGROUND: Angiofibroblastic changes of a musculotendinous origin at the medial epicondyle characterize medial epicondylitis of the elbow. Although nonsurgical treatment is the primary approach for medial epicondylitis, surgical treatment should be considered when conservative therapy fails. This study reports the results of surgical treatment of medial epicondylitis monitored for more than 5 years. METHODS: This study included 55 patients with 63 cases of medial epicondylitis between 2000 and 2010...
October 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27386445/coracoid-syndrome-a-neglected-cause-of-anterior-shoulder-pain
#16
Antonio Gigante, Carlo Bottegoni, Pamela Barbadoro
PURPOSE: the present prospective open-label study was designed to gain further insights into a condition thought to constitute a neglected but not uncommon syndrome characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process, not related to rotator cuff or pectoralis minor tendinopathy, long head of the biceps tendon disorders, or instability. The aim was to clarify its prevalence, clinical characteristics, differential diagnosis and response to corticosteroid injections...
January 2016: Joints
https://www.readbyqxmd.com/read/27357960/-open-wedge-osteotomy-of-the-glenoid-for-treatment-of-posterior-shoulder-instability-with-increased-glenoid-retroversion
#17
J Pogorzelski, S Braun, A B Imhoff, K Beitzel
OBJECTIVE: Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. INDICATIONS: Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously failed conservative or surgical treatment. CONTRAINDICATIONS: General contraindications against surgery. Relative contraindications: osteoporosis, nicotine abuse, or suspected patient noncompliance...
December 2016: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27259482/-arthroscopic-subacromial-decompression
#18
REVIEW
S Lerch, S Elki, M Jaeger, T Berndt
OBJECTIVE: Coracoacromial ligament release to widen the subacromial space, resection of the anterior undersurface of the acromion and, if needed, caudal exophytes at the acromioclavicular joint. INDICATIONS: All types of outlet impingement after 3 months of conservative treatment. CONTRAINDICATIONS: Impingement syndrome with instability/muscular imbalance, massive rotator cuff tear, unstable os acromionale, posterior-superior impingement, joint infection, freezing phase of a secondary frozen shoulder...
October 2016: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/26818554/slap-lesions-a-treatment-algorithm
#19
Matthias Brockmeyer, Marc Tompkins, Dieter M Kohn, Olaf Lorbach
Tears of the superior labrum involving the biceps anchor are a common entity, especially in athletes, and may highly impair shoulder function. If conservative treatment fails, successful arthroscopic repair of symptomatic SLAP lesions has been described in the literature particularly for young athletes. However, the results in throwing athletes are less successful with a significant amount of patients who will not regain their pre-injury level of performance. The clinical results of SLAP repairs in middle-aged and older patients are mixed, with worse results and higher revision rates as compared to younger patients...
February 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/26714819/arthroscopic-bankart-repair-have-we-finally-reached-a-gold-standard
#20
Alessandro Castagna, Raffaele Garofalo, Marco Conti, Brody Flanagin
Traditionally, surgical stabilization of the unstable shoulder has been performed through an open incision. Arthroscopic Bankart repair with suture anchors is now widely considered the treatment of choice for anterior shoulder instability in patients who have failed conservative management. Many different factors have now been elucidated for adequate treatment of glenohumeral instability. Because of technical advances in instability repair combined with an increased understanding of factors that lead to recurrent instability, the outcomes following arthroscopic Bankart repair have significantly improved and approach those of open techniques...
February 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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