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Shoulder dislocation

Richard Pescatore, Andrew Nyce, Nachi Gupta, Jeffrey Nusbaum
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral...
June 1, 2018: Emergency Medicine Practice
Stefanie E Williams, Anthony J Hackett, Christian Jensen, Mark L Riddle
Posterior shoulder dislocation should be considered in the differential diagnosis of acute shoulder pain and immobility following trauma. Although far less common then the anterior dislocation, it is associated with high rates of comorbidity. Seventy-nine percent of posterior shoulder dislocations are missed on initial presentation, which is partially responsible for the high rate of comorbidity associated with these injuries. The mechanism of injury is varied from generalized seizure to minor trauma, which adds to the complexity of the diagnosis...
June 13, 2018: Military Medicine
Jennifer Kurowicki, Jacob J Triplet, Derek D Berglund, Thomas Zink, Samuel Rosas, Jonathan C Levy
CASE: An 80-year-old woman sustained a fracture-dislocation of the proximal aspect of the humerus with a near-complete brachial plexopathy, which was successfully managed acutely using a reverse shoulder arthroplasty (RSA) with repair of the greater and lesser tuberosities. The palsy, which was confirmed with nerve conduction studies, recovered uneventfully along with functional improvement of the shoulder. At the most recent follow-up, there was complete resolution of the plexopathy, with excellent, pain-free range of motion...
June 13, 2018: JBJS Case Connector
Carla Teresa Barbosa de Oliveira, Elpídio da Graça, Vânia Aparecida Fanelli
Objective: To evaluate patients diagnosed with posterior four-part fracture-dislocations of the proximal humerus, that were surgically treated with osteosynthesis, regarding their clinical and functional outcomes. Methods: A prospective observational study of eight patients from the same hospital institution in the interior of São Paulo State (Brazil), through individual interviews using the UCLA, DASH, and Constant international scores. The active movements included in the scores plus the range of motion of the affected and non-affected limb were measured...
May 2018: Revista Brasileira de Ortopedia
Benedikt Schliemann, Lukas F Heilmann, Michael J Raschke, Helmut Lill, J Christoph Katthagen, Alexander Ellwein
Background: This study analyzed the indications for conservative management of isolated greater tuberosity (GT) fractures. The rate of secondary interventions for failed conservative treatment was also assessed. Methods: A retrospective data evaluation of isolated GT fractures was performed from the clinical database of two level-I trauma centers from January 2010 to June 2017. Conservatively treated GT fractures were identified and subdivided according to etiology, morphology, and amount of initial displacement...
2018: Obere Extremität
Baichuan Wang, Qiang Wu, Zhicai Zhang, Jianxiang Liu, Zengwu Shao
BACKGROUND: Surgical reconstruction after total scapulectomy presents a great challenge. Currently, the constrained scapular prosthesis reconstruction is considered as the most effective and promising method. However, the mid- to long-term functional outcomes and complications of this procedure are unclear. METHODS: We retrospectively analyzed eight patients with scapular malignant tumors treated by total scapulectomy and constrained scapular prosthesis reconstruction between 2011 and 2013...
June 7, 2018: Journal of Surgical Oncology
Radwan G Metwaly, Kareem Edres
Introduction: Acromioclavicular (AC) joint injury associated with coracoid process (CP) fracture is a rare injury and only case reports had been published in the literature. Although AC joint injury is not uncommon, there is controversy as regard the best stabilization method whether to use wires, hook plate, arthroscopic reconstruction or the recently described techniques of anatomic restoration of both the coracoclavicular (CC) and acromioclavicular (AC) ligaments to add stability in both the vertical as well as the horizontal plane for the AC joint...
June 2018: Trauma Case Reports
Steven F DeFroda, Brett D Owens
Shoulder instability represents a spectrum of disease, ranging from subluxation to dislocation. It may present acutely after trauma or chronically as a result of multiple events. Physical examination is a key component in evaluating the degree of instability and laxity present; however, in-office guarding or apprehension may limit the examination. In addition, patient anatomy or operator technique may limit the accuracy and reproducibility of examination maneuvers such as the load-shift test. We propose an arthroscopic modification to the load-shift technique involving direct visualization to assess the direction and degree of shoulder instability...
March 2018: Arthroscopy Techniques
Martine Enger, Stein Arve Skjaker, Knut Melhuus, Lars Nordsletten, Are Hugo Pripp, Stefan Moosmayer, Jens Ivar Brox
INTRODUCTION: Shoulder injuries are commonly encountered in emergency departments. In spite of this, the epidemiology is only partly known, and soft tissue injuries in particular remain unclear. The aim of this study was to obtain an overview of shoulder injuries in a general population cohort, and to estimate the relative proportion of the main injury categories soft tissue injuries, fractures and dislocations, as well as their variation with age and gender. PATIENTS AND METHODS: We registered prospectively all patients admitted with a suspected shoulder injury at a combined casualty and primary health care facility during one year...
May 22, 2018: Injury
Marcel Émond, Charles Gariepy, Valérie Boucher, Gregory W Hendey
BACKGROUND: Shoulder dislocation is one of the most frequent dislocations encountered by emergency physicians. Typical emergency care usually includes performing both prereduction and postreduction radiography. However, selective radiography has the potential benefits of reducing emergency department (ED) time and radiation exposure. OBJECTIVES: To refine and combine two existing clinical decision rules for selective radiography in the ED management of anterior shoulder dislocation, thus creating the Fresno-Quebec rule (FQR)...
May 31, 2018: Journal of Emergency Medicine
Jian Xu, Haifeng Liu, Wei Lu, Dingfu Li, Weimin Zhu, Kan Ouyang, Bing Wu, Liangquan Peng, Daping Wang
BACKGROUND: Rockwood type IV acromioclavicular joint (ACJ) dislocation is a trauma usually needs surgical treatment. Paired EndoButton technique (PET) is used in treating such condition. However, the effect of using different types of PET (single versus double PET) for fixation remains controversial. This study aims to evaluate and compare the efficacy of single and double PET and to provide a suitable option for the surgeons. METHODS: We retrospectively reviewed the charts of patients with acute Rockwood type IV ACJ dislocation who had undergone arthroscopic fixation using single or double PET fixation between March 2009 and March 2015...
May 24, 2018: BMC Musculoskeletal Disorders
D A Songahir Christophe, Korsaga Alexandre, Tinto Sayouba, Sawadogo Mamoudou, Kafando Hamado, Ouedraogo Anatole Jean Innocent, Zeida Charles, Keita Namori, Tall Mohamed
We report an exceptional clinical case of an ipsilateral dislocation fracture of the shoulder and right elbow, realizing a "swinging arm". Following a violent road accident, patient S.I, a 43-year-old left-handed sports educator, presented with an antero-medial shoulder dislocation fracture and a posterolateral ipsilateral elbow fracture-dislocation. The reduction in urgency, followed by the orthopedic compression by Mayo Clinic and functional rehabilitation, allowed obtaining a good result after seven months...
2018: Open Orthopaedics Journal
Robert Z Tashjian, Brook I Martin, Cassandra A Ricketts, Heath B Henninger, Erin K Granger, Peter N Chalmers
BACKGROUND: Instability is the most common complication after reverse total shoulder arthroplasty (rTSA). In the native glenohumeral joint, in addition to full dislocations, more subtle forms of instability exist. However, the incidence of more subtle forms of instability, the factors associated with instability, and the effect of instability on validated outcome scores after rTSA remain poorly understood. QUESTIONS/PURPOSES: (1) After rTSA, what is the risk of instability, including more subtle forms of subjective instability? (2) What are the factors associated with instability? (3) Are more subtle forms of instability associated with lower American Shoulder and Elbow Surgeons (ASES) functional outcome scores than those patients without instability? METHODS: A total of 168 rTSAs were performed during the study period...
May 17, 2018: Clinical Orthopaedics and related Research
Richard Pescatore, Andrew Nyce
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral...
June 2018: Emergency Medicine Practice
Ying-Cheng Huang, Shan-Wei Yang, Chun-Yu Chen, Kai-Cheng Lin, Jenn-Huei Renn
BACKGROUND: Here, we compared the clinical and radiographic outcomes between coracoclavicular (CC) fixation with Mersilene tape and hook plate for acute unstable acromioclavicular (AC) joint dislocation treatment. METHODS: We enrolled 49 patients with unstable acute AC dislocation who, between January 2010 and January 2014, underwent surgery with single CC suture fixation with Mersilene tape (M group, 25 cases) or clavicle hook plate (H group, 24 cases). In M and H groups, the average age was 43...
May 16, 2018: Journal of Orthopaedic Surgery and Research
Jeremy S Somerson, Jason E Hsu, Moni B Neradilek, Frederick A Matsen
BACKGROUND: Most of the literature on shoulder arthroplasty failure comes from high-volume centers. These reports tend to exclude the experience of community orthopedic surgeons, who perform most of the shoulder joint replacements. METHODS: We analyzed the failure reports mandated by the US Food and Drug Administration for all hospitals. Each reported event from 2012 to 2016 was characterized by implant, failure mode, and year of surgery. RESULTS: For the 1673 anatomic arthroplasties, the most common failure modes were glenoid component failure (20...
May 11, 2018: Journal of Shoulder and Elbow Surgery
David Haeni, Matthieu Sanchez, Plath Johannes, Lilling Victoria, Dan Henderson, Jeremy Munji, Kalojan Petkin, Laurent Lafosse
PURPOSE: The aim of this study was to describe a one-step arthroscopic anterior and posterior bone block augmentation technique for bidirectional shoulder instability and to present preliminary results. METHODS: Seven consecutive patients who underwent a concomitant anterior and posterior bone block procedure between 2007 and 2015 were retrospectively reviewed. Clinical scores, return to sport rate, and complications were assessed. Radiological outcome, with CT scan at 6 months and plain radiographs at final follow-up were reviewed...
May 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Richard S Page, Vishal Pai, Kevin Eng, Gregory Bain, Stephen Graves, Michelle Lorimer
BACKGROUND: Glenoid loosening is a common mode of failure after total shoulder arthroplasty (TSA). Newer cementless glenoid components have been introduced to promote biological fixation with the aim to decrease glenoid loosening. Limited data are available comparing revision rates between cemented and cementless glenoid fixation in TSA. The study aim was to compare the revision rates of cemented and cementless design glenoid components used in conventional TSA performed for the diagnosis of osteoarthritis...
May 8, 2018: Journal of Shoulder and Elbow Surgery
M Bourgain, S Hybois, P Thoreux, O Rouillon, P Rouch, C Sauret
The golf swing is a complex full body movement during which the spine and shoulders are highly involved. In order to determine shoulder kinematics during this movement, multibody kinematics optimization (MKO) can be recommended to limit the effect of the soft tissue artifact and to avoid joint dislocations or bone penetration in reconstructed kinematics. Classically, in golf biomechanics research, the shoulder is represented by a 3 degrees-of-freedom model representing the glenohumeral joint. More complex and physiological models are already provided in the scientific literature...
April 25, 2018: Journal of Biomechanics
Jonas Pogorzelski, Erik M Fritz, Marilee P Horan, J Christoph Katthagen, Matthew T Provencher, Peter J Millett
BACKGROUND: Recurrent instability is a frequent complication following arthroscopic Bankart repair. The purpose of this study was to investigate risk factors for poor patient-reported clinical outcome scores and failure rates. METHODS: Patients who underwent arthroscopic Bankart repair at least 2 years earlier were included. Preoperative and postoperative Single Assessment Numeric Evaluation; Quick Disabilities of the Arm, Shoulder and Hand; American Shoulder and Elbow Surgeons; and satisfaction scores were collected...
May 2, 2018: Journal of Shoulder and Elbow Surgery
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