- Discussion:
-
ON THE ARTICULATIONS. by Hippocrates.
-
pathoanatomy:
-
bankart lesion
-
hill sachs lesion
-
stabilizers of the shoulder:
-
muscular stabilizers:
-
static stabilizers
-
anteroinferior glenohumeral ligament:
-
mechanism of anterior dislocations:
- combination of abduction, extension, and a posteriorly directed force applied to the arm;
- humeral head is driven anteriorly, tearing the
shoulder capsule, detaching the labrum from the glenoid,
and producing a compression frx of the humeral head;
- arm position during the traumatic episode leads to
variations of anterior dislocation:
-
associated injuries:
- references:
-
Mechanisms of glenohumeral joint stability.
-
Lesions in different types of anterior glenohumeral joint dislocation. An experimental study.
-
classification of anterior dislocation:
-
chronic unreduced dislocations:
-
fracture dislocation:
-
multidirectional instability:
-
recurrent anterior instability:
-
natural history:
- Physical Exam:
-
associated injuries;
- Radiographic Studies:
-
Apical Oblique View
-
Axillary View
-
Hill Sachs Lesion
-
True AP - (35 deg oblique to the body)
-
Transscapular View
-
Stryker Notch view for picking up a
Hill Sachs;
-
West Point Axillary View:
- osseous
bankart defect on anteroinferior glenoid rim;
-
discussion:
- common radiographic changes seen following anterior dislocations, include
Hill Sachs lesion,
calcification along the antero-inferior aspect of the glenoid rim (or fracture of the glenoid rim);
- additional findings include fracture, erosion, blunting of the anterior glenoid rim;
- Initial Treatment:
-
work up for shoulder dislocation:
-
reduction methods:
- Non Operative Treatment:
- may be indicated for patients w/
multidirectional instability, for voluntary instability, for posterior
glenohumeral instability, & for those who need a supranormal ROM - such as base ball pitchers;
- references:
-
Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus.
-
Immobilization after primary dislocation of the shoulder.
-
Treatment of primary anterior shoulder dislocation in patients older than 40 years of age.
-
Treatment of instability of the shoulder with an exercise program.
-
Immobilization in External Rotation After Shoulder Dislocation Reduces the Risk of Recurrenc. A Randomized Controlled Trial
- Surgical Treatment:
-
Anterior Shoulder Reconstruction: (
anterior approach to shoulder):
-
Arthroscopic Shoulder Reconstruction:
Long-term results of staple capsulorrhaphy for anterior instability of the shoulder.
Long-term results of staple capsulorrhaphy for anterior instability of the shoulder.
Diagnosis and treatment of traumatic anterior instability of the shoulder.
The diagnosis and treatment of anterior instability in the throwing athlete.
Results of a modified Putti-Platt operation for recurrent shoulder dislocations and subluxations.
Hypoplasia of the glenoid. A review of sixteen patients.
Experiments on the tensile strength of the anterior capsule structures of the shoulder joint in man. Reeves B: J Bone Joint Surg 1968; 50B:858-865.
Dynamic stability of the glenohumeral joint. Saha AK: Acta Orthop Scand 1971;42:491-505.
Anterior shoulder instability.
Acute shoulder dislocations: factors influencing diagnosis and treatment.
Dislocation arthropathy of the shoulder.
Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint.
Year Book: Anterior Capsulolabral Reconstruction of the Shoulder in Athletes in Overhand Sports.
Redislocation of the Shoulder During the First Six Weeks After a Primary Anterior Dislocation: Risk Factors and Results of Treatment
The HAGL lesion: An arthroscopic technique for repair of humeral avulsion of the glenohumeral ligaments.
..................................... ................................. .......................................... ....................................
