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https://www.readbyqxmd.com/read/29291289/glenohumeral-dislocation-with-engaging-hill-sachs-lesion
#1
Rob Halle, Jeffery Dolbeer, Donald Goss
A 20-year-old military cadet injured his left shoulder after landing in an abducted and externally rotated arm position while participating in a mandatory obstacle course. Following examination, the individual was taken to the emergency department, where radiographs confirmed an anterior dislocation of the glenohumeral joint and a large Hill-Sachs lesion wedged on the glenoid. Results of noncontrast magnetic resonance imaging and a computed tomography scan confirmed the presence of a large Hill-Sachs lesion...
January 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29248765/chronic-anterior-shoulder-instability-with-significant-hill-sachs-lesion-arthroscopic-bankart-with-remplissage-versus-open-latarjet-procedure
#2
A Bah, G M Lateur, B T Kouevidjin, J Bassinga, M Issa, A Jaafar, E Beaudouin
BACKGROUND: The objective of this study was to compare short-term shoulder stability after arthroscopic Bankart repair with remplissage versus the open Latarjet procedure in patients who had chronic anterior shoulder instability with a significant Hill-Sachs lesion. HYPOTHESIS: The dislocation recurrence rate is higher after Bankart repair with remplissage than after open Latarjet. PATIENTS AND METHODS: An observational non-randomised retrospective cohort study was conducted at two surgical centres in patients treated for chronic anterior shoulder instability with a significant Hill-Sachs defect between January 2009 and July 2014...
December 14, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29242794/bilateral-anterior-shoulder-dislocation-in-the-elderly-a-case-report-and-review-of-the-literature
#3
Kristian Nikolaus Schneider, Benedikt Schliemann, Salomon M Manz, Pranai K Buddhdev, Georg Ahlbäumeri
Introduction: Bilateral shoulder dislocations are rare and a diagnostic as well as a therapeutic challenge. Case Report: We report the case of a 67-year-old male who fell while skiing and suffered a bilateral anterior shoulder dislocation associated with a four-part proximal humerus fracture on the left side and an osseous avulsion of the rotator cuff, a Pulley lesion, and a Hill-Sachs lesion on the right side. In addition, we searched the PubMed database using the terms "bilateral shoulder dislocation" and also "bilateral glenohumeral dislocation"...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29216740/new-concepts-of-radiologic-preoperative-evaluation-of-anterior-shoulder-instability-on-track-and-off-track-lesions
#4
Aishwarya Gulati, Riham Dessouky, Vibhor Wadhwa, Drew Sanders, Avneesh Chhabra
The shoulder is the most frequently dislocated joint in the body due to a larger range of motion and a small area of articulation between the humeral and glenoid surfaces. Traumatic shoulder dislocations, especially those associated with injury to the labroligamentous or bony stabilizers of the joint, lead to further reduction of articular surface contact with resultant glenohumeral instability and recurrent shoulder dislocations. Imaging plays an increasingly important role in the preoperative evaluation of patients with traumatic shoulder instability by evaluating glenohumeral bone loss (uni- or bipolar), assessing soft tissue injuries and identifying patients at risk of postoperative recurrence...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29216696/-undetected-traumatic-posterior-glenohumeral-dislocation
#5
J A Rosas-Medina
INTRODUCTION: Glenohumeral dislocation (GHD) is frequent, but traumatic posterior glenohumeral dislocation (TPGHD) is rare, with an incidence of 1-4% of all GHD. The diagnosis is a challenge: sometimes, it can be omitted due to incorrect diagnosis, absence of consideration in the differential diagnosis, suboptimal radiographic evaluation and an absence of characteristic signs and symptoms; missed diagnosis reaches 60-79% and the diagnosis can delay from 24 hours to a year. OBJECTIVE: To transmit previous experiences to provide support for better diagnosing TPGHD, favoring appropriate attention...
July 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29198939/three-dimensional-computed-tomography-measurement-accuracy-of-varying-hill-sachs-lesion-size
#6
Anthony Ho, Michael D Kurdziel, Denise M Koueiter, J Michael Wiater
BACKGROUND: The glenoid track concept has been proposed to correlate shoulder stability with bone loss. Accurate assessment of Hill-Sachs lesion size preoperatively may affect surgical planning and postoperative outcomes; however, no measurement method has been universally accepted. This study aimed to assess the accuracy and reliability of measuring Hill-Sachs lesion sizes using 3-dimensional (3D) computed tomography (CT). METHODS: Nine polyurethane humerus bone substitutes were used to create Hill-Sachs lesions of varying sizes with a combination of lesion depth (shallow, intermediate, and deep) and width (small, medium, and large)...
November 30, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29135565/pediatric-and-adolescent-anterior-shoulder-instability-clinical-management-of-first-time-dislocators
#7
Kenneth M Lin, Evan W James, Elad Spitzer, Peter D Fabricant
PURPOSE OF REVIEW: The purpose of this review is to discuss the epidemiology, pathoanatomy, diagnosis, and clinical management of pediatric and adolescent patients following a first-time shoulder dislocation. RECENT FINDINGS: Shoulder instability is becoming increasingly common as pediatric and adolescent patients engage in earlier organized sports competition. Recommended treatment following a first-time glenohumeral dislocation event in adolescents depends on several factors, but surgical stabilization is becoming more frequently performed...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29132328/posterior-shoulder-dislocation-with-associated-reverse-hill-sachs-lesion-treatment-options-and-functional-outcome-after-a-5-year-follow-up
#8
Markus Guehring, Simon Lambert, Ulrich Stoeckle, Patrick Ziegler
BACKGROUND: The current study describes several surgical techniques for the treatment of the reverse Hill - Sachs lesion after posterior shoulder dislocation; we also aimed to present long term results followed for a minimum of five years. METHODS: This study is a prospective case series of 17 patients who were treated in our clinic between 2008 and 2011. Patients with a defect size smaller than 25% of the articular surface were treated conservatively. An endoprosthesis of the glenohumeral joint was implanted in patients with a defect size bigger than 40%...
November 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29125820/rafting-technique-without-bone-grafting-in-reverse-hill-sachs-lesions
#9
Meriç Çırpar, Birhan Oktaş, Bülent Dağlar
In this article, we report a case of bilateral posterior shoulder instability, having reverse Hill-Sachs lesions of 25 to 50% of the articular surface on the right side, and of 50% on the left side. The defects were anatomically reconstructed after tuberculum minus osteotomy by elevation of the articular surface and buttressing with raft screws without graft usage. Early rehabilitation with pendulum shoulder exercises was started at third postoperative day. At postoperative sixth week, patient had full range of motion without instability and pain...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29124296/-diagnostics-and-treatment-of-posterior-shoulder-instability
#10
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/29117482/zero-echo-time-imaging-of-the-shoulder-enhanced-osseous-detail-by-using-mr-imaging
#11
Ryan E Breighner, Yoshimi Endo, Gabrielle P Konin, Lawrence V Gulotta, Matthew F Koff, Hollis G Potter
Purpose To determine the intermodality agreement of morphologic grading and clinically relevant quantitative measurements between computed tomography (CT) and zero echo time (ZTE) magnetic resonance (MR) imaging of the shoulder. The primary objective was to demonstrate the clinical applicability of ZTE in osseous shoulder imaging. Materials and Methods Thirty-four patients undergoing standard-of-care (SOC) MR imaging with concomitant CT were enrolled in this institutional review board-approved study. ZTE images were acquired after SOC MR imaging...
November 8, 2017: Radiology
https://www.readbyqxmd.com/read/29114335/imaging-of-the-unstable-shoulder
#12
Paolo Baudi, Manuela Rebuzzi, Giovanni Matino, Fabio Catani
Background: Unstable shoulder can occur in different clinical scenarios with a broad spectrum of symptoms and presentations: first-time (or recurrent) traumatic acute shoulder anterior dislocation or chronic anterior instability after repeated dislocations.Imaging in unstable shoulder is fundamental for choosing the right treatment preventing recurrence.The goal of imaging depends on clinical scenario and patient characteristics. Method: Careful selection and evaluation of the imaging procedures is therefore essential to identify, characterize and quantify the lesions...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29101634/understanding-the-hill-sachs-lesion-in-its-role-in-patients-with-recurrent-anterior-shoulder-instability
#13
REVIEW
Jake A Fox, Anthony Sanchez, Tyler J Zajac, Matthew T Provencher
PURPOSE OF REVIEW: The purpose of this study is to provide an update to the orthopedic field in regard to treatment of the Hill-Sachs lesion and anterior shoulder instability. The review highlights the most current knowledge of epidemiology, clinical evaluation, and surgical methods used to treat Hill-Sachs lesions. It also details the relevant clinical and surgical findings that have been made throughout the literature in the past couple of years. RECENT FINDINGS: The most recent literature covering the Hill-Sachs lesion has focused on the relatively new and unexplored topic of the importance of concomitant injuries while treating a humeral head defect...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29058754/partial-resurfacing-for-humeral-head-defects-associated-with-recurrent-shoulder-instability
#14
Matthew C Bessette, Nicholas C Frisch, Pradeep Kodali, Morgan H Jones, Anthony Miniaci
Recurrent traumatic shoulder instability is a complex clinical entity that commonly affects young, active patients. Humeral head defects are frequently associated with this condition, but specific treatment to stabilize the shoulder is rarely needed. Management options for defects of the humeral head that do necessitate treatment carry various risks and disadvantages, including the need for bone or soft tissue healing, complications related to hardware, and loss of motion. Partial prosthetic resurfacing has been reported as a treatment option...
October 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28994025/applying-the-glenoid-track-concept-in-the-management-of-patients-with-anterior-shoulder-instability
#15
REVIEW
Amit M Momaya, John M Tokish
PURPOSE OF REVIEW: The purpose of this paper is to evaluate the recent evolution in the treatment of anterior shoulder instability and the dynamic interaction between the glenoid and Hill-Sachs lesion. RECENT FINDINGS: Through the glenoid track concept, glenoid- and humeral-sided bone loss are evolving away from being approached as separate entities. Recent cadaveric studies have validated the glenoid track concept. Moreover, a recent clinical study has demonstrated a much higher rate of failure after arthroscopic Bankart repair for shoulders that were off track...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28988351/management-of-complex-anterior-shoulder-instability-a-case-based-approach
#16
REVIEW
Nathan Olszewski, Michael Gustin, Emily J Curry, Xinning Li
PURPOSE OF THE REVIEW: The goal of this review is to provide a guide on surgical decision-making options for complex anterior shoulder instability using a case-based approach. RECENT FINDINGS: Arthroscopic Bankart repair is well documented for having successful outcomes in patients with isolated labral tear involvement with minimal bone loss. Latarjet is a generally accepted procedure in patients with 20-30% glenoid bone loss. When bone loss exceeds that which cannot be managed through Latarjet, a range of options exist and are highly dependent upon the extent of osseous deficiency on both the glenoid and humeral sides, surgeon experience, and patient-specific factors...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28983224/arthroscopic-treatment-of-osseous-instability-of-the-shoulder
#17
REVIEW
David A Porter, Michael Birns, Sarah J Hobart, Marc Kowalsky, Gregory J Galano
BACKGROUND: Bony deficiency of the anteroinferior glenoid rim as a result of a dislocation can lead to recurrent glenohumeral instability. These lesions, traditionally treated by open techniques, are increasingly being treated arthroscopically as our understanding of the pathophysiology and anatomy of the glenohumeral joint becomes clearer. Different techniques for arthroscopic management have been described and continue to evolve. While the success of the repair is surgeon dependent, the recent advances in arthroscopic shoulder surgery have contributed to the growing acceptance of arthroscopic reconstruction of glenoid bone defects to restore stability...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28979604/management-of-humeral-defects-in-anterior-shoulder-instability
#18
Maria Valencia Mora, Miguel Ángel Ruiz-Ibán, Jorge Diaz Heredia, Raquel Ruiz Diaz, Ricardo Cuéllar
BACKGROUND: A Hill Sachs lesion is a posterior-superior bony defect of the humeral head caused by a compression of the hard glenoid rim against the soft cancellous bone in the context of an anterior instability episode. The presence of these humeral defects increases with the number of dislocations and larger lesions are associated with a greater chance of development of recurrent instability and recurrence after surgery. Also its location and pattern, in particular the so-called engaging Hill-Sachs, are associated with poor prognosis...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979598/evaluation-and-management-of-failed-shoulder-instability-surgery
#19
António Cartucho, Nuno Moura, Marco Sarmento
BACKGROUND: Failed shoulder instability surgery is mostly considered to be the recurrence of shoulder dislocation but subluxation, painful or non-reliable shoulder are also reasons for patient dissatisfaction and should be considered in the notion. METHODS: The authors performed a revision of the literature and online contents on evaluation and management of failed shoulder instability surgery. RESULTS: When we look at the reasons for failure of shoulder instability surgery we point the finger at poor patient selection, technical error and an additional traumatic event...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979596/treatment-of-the-posterior-unstable-shoulder
#20
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
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