Dislocations around the shoulder
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
Neviaser et al. reported on 31 patients with weakness of arm abduction following a primary anterior dislocation of the shoulder.8 The mean age was 58 years and the mean followup was 5 years. Of the 19 patients with an associated rotator cuff tear alone, all had a reduction in pain (none had pain at night) and 16 patients regained full abduction following intervention. Itoi et al. reported on 12 patients over the age of 40 years with a rotator cuff tear associated with a traumatic anterior dislocation of the shoulder.28 Open repair was performed in 11 patients, with eight (73%) reporting a good or excellent outcome at a mean of 32 months following surgery. No repair of the Bankart lesion was performed in these patients and no effect on the outcome was reported by the authors.
Arthroscopic anterior instability repair
Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss in Atlas of Advanced Shoulder Arthroscopy, 2017
A standard posterior arthroscopic portal is created and the arthroscopic camera is inserted. The anterosuperior and antero-inferior portals are created under direct visualization using a spinal needle to allow for an accurate portal. A diagnostic arthroscopy is performed to identify the Bankart lesion (Figure 4.3). The arthroscope is then moved to the anterosuperior portal with instrumentation using an 8.25 mm cannula in the anterior mid-glenoid portal and a posterior portal. A blanket roll is placed into the axilla to provide additional lateral distraction and improve arthroscopic view to the 6-o'clock position, as well as a clear view of the glenoid, labrum, and capsular structures (Figure 4.4). The displaced labrum is visualized and inspected further using an arthroscopic probe (Figure 4.5).
Shoulder dislocation
Alisa McQueen, S. Margaret Paik in Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
The four most common complications are Bankart lesions (up to 87%), Hill-Sachs lesions (54%–76%), rotator cuff tears (14%), and axillary nerve injuries (3%). A Bankart lesion is a deformity of the glenoid rim which can lead to joint instability. A Hill-Sachs deformity is a cortical depression in the posterolateral head of the humerus that occurs as a result of the force of the humeral head against the glenoid rim during the dislocation. Rotator cuff tears can also occur due to the force of the dislocation and can cause shoulder instability. The axillary nerve, which travels in close proximity to the humeral head, can be damaged during the dislocation, resulting in loss of sensation over the deltoid and difficulty with arm abduction.
Simultaneous bilateral shoulder dislocation during pilates reformer exercise: A case report
Published in Physiotherapy Theory and Practice, 2023
Metin Ergün, İhsan Yörük, Ogün Köyağasioğlu
On physical examination at the tenth day after the injury and consequent reduction, the right shoulder had mild restriction of internal rotation (IR) and the left shoulder had severe restriction of IR. No sensitivity and difficulty existed during shoulder elevation. Magnetic resonance imaging (MRI) performed two weeks after injury was reviewed. Findings for the left shoulder were appearance of fissure on tuberculum majus, a linear fibrous Bankart lesion on anterior labrum, edema distal to the supraspinatus tendon and a partial rupture to the distal tendon of subscapularis muscle and effusion around the biceps muscle tendon (Figure 2a). On her right shoulder, there was Hill-Sachs deformity posterolateral to the humeral head, edema, and partial rupture distal to the supraspinatus tendon, and edema in bone marrow (Figure 3b).
Accuracy of internet images of ligamentous knee injuries
Published in The Physician and Sportsmedicine, 2019
Steven F. DeFroda, Steven L. Bokshan, Emil Stefan Vutescu, Kayleigh Sullivan, Brett D. Owens
It is not entirely surprising that these injuries are misrepresented during an Internet search. These injuries are commonly encountered in athletics, leading to many different websites having information on ‘ACL tears’ both on medical and athletics websites which do not have any input from trained physicians. While some incorrect images involved incorrectly labeling or drawing the ligament, other results where images of athletes with the injury in question, or images of braces for ligamentous injuries, or exercises for the aforementioned injury. As we limited our review of the images to the first 100 results, it was surprising to obtain so many extraneous images. The danger with these Internet based search engines is that the content is non-peer reviewed. Freeman et al. found similar results when examining the Internet search engine results for intra-articular shoulder pathology[10]. The authors reported that when searching ‘Bankart lesion’, an incorrect image was present 28% of the time, leading the authors to caution physicians to critically review the material they recommend for their patients[10].
Comparison of Two Posterior Soft-Tissue Repair Techniques to Prevent Dislocation after Total Hip Arthroplasty Using a Posterolateral Approach
Published in Journal of Investigative Surgery, 2021
Matthew Jian-Qiao Peng, Hong-Wen Xu
The following references in the Journal of Investigative Surgery describe experiments that involve repairing abdominal, shoulder and hip lesions, either by platelet plasma, heterotopic bone, soft tissue, or bioabsorbable rivet. For instance, Aliabadi-Wahle et al. [2] used synthetic materials (TMS-1 and TMS-2 vs. polytetrafluoroethylene and polypropylene etc.) to repair abdominal wall fascial defects covered by soft tissue and reaffirmed that fascial closure is preferable only when soft tissue coverage over the repair cannot be achieved. They also found that TMS-2 is well tolerated. In a study published in 2007, Collins et al. [3] conducted a biomechanical study of Bankart lesion fixation comparing biodegradable ArthroRivet tack vs. suture repair and suggested the suitability of the bioabsorbable rivet for use in Bankart repair. This indicated that bioabsorbable fixation is possible and practical in soft tissue procedures performed in the shoulder. In 2011, Klaassen and Pietrzak [4] conducted a retrospective investigation of platelet-rich plasma application and heterotopic bone formation following total hip arthroplasty. They discovered that 21.3% of the control patients developed heterotopic bone compared to 12.9% of the treatment patients after one year, and this difference was not significant. This did not influence the severity of heterotopic ossification, as autologous blood products play less of a role in total hip arthroplasty. However, none of these studies address the topical technique of TB or TT repair, so Wu et al.’s paper raises interesting possibilities.
Related Knowledge Centers
- Surgery
- Bone Fracture
- Scapula
- Humerus
- Injury
- Dislocated Shoulder
- Glenoid Labrum
- Hill–Sachs Lesion
- Glenoid Fossa
- Medical Imaging