- Discussion:
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ON THE ARTICULATIONS. by Hippocrates.
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pathoanatomy:
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bankart lesion
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hill sachs lesion
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stabilizers of the shoulder:
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dynamic / muscular stabilizers:
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static stabilizers
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anteroinferior glenohumeral ligament:
- references:
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Pathoanatomy of first-time, traumatic, anterior glenohumeral subluxation events.
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mechanism of anterior dislocations:
- combination of abduction, extension, and a posteriorly directed force applied to the arm;
- humeral head is driven anteriorly, tearing
shoulder capsule, detaching labrum from glenoid, and producing a compression frx of humeral head;
- arm position during the traumatic episode leads to
variations of anterior dislocation:
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associated injuries:
- references:
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Mechanisms of glenohumeral joint stability.
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Lesions in different types of anterior glenohumeral joint dislocation. An experimental study.
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classification of anterior dislocation:
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chronic unreduced dislocations:
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fracture dislocation:
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multidirectional instability:
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recurrent anterior instability:
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natural history:
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Year Book: Anterior Capsulolabral Reconstruction of the Shoulder in Athletes in Overhand Sports.
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The diagnosis and treatment of anterior instability in the throwing athlete.
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Dislocation arthropathy of the shoulder.
- Physical Exam:
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associated injuries;
- Radiographic Studies:
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Apical Oblique View
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Axillary View
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Hill Sachs Lesion
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True AP - (35 deg oblique to the body)
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Transscapular View
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Stryker Notch view for picking up a
Hill Sachs;
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West Point Axillary View:
- osseous
bankart defect on anteroinferior glenoid rim;
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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 of Dislocation:
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work up for shoulder dislocation:
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reduction methods:
- Non Operative Treatment:
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natural history:
- 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:
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Immobilization after primary dislocation of the shoulder.
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Treatment of instability of the shoulder with an exercise program.
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Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus.
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Treatment of primary anterior shoulder dislocation in patients older than 40 years of age.
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Immobilization in External Rotation After Shoulder Dislocation Reduces the Risk of Recurrenc. A Randomized Controlled Trial
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Redislocation of the Shoulder During the First Six Weeks After a Primary Anterior Dislocation: Risk Factors and Results of Treatment
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Conservative therapy of antero-inferior glenoid fractures
- Surgical Treatment:
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Open Anterior Shoulder Reconstruction: (
anterior approach to shoulder):
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Arthroscopic Shoulder Reconstruction:
Diagnosis and treatment of traumatic anterior instability of the shoulder.
Hypoplasia of the glenoid. A review of sixteen patients.
Anterior shoulder instability.
Acute shoulder dislocations: factors influencing diagnosis and treatment.
Treatment of chronic glenoid defects in the setting of recurrent anterior shoulder instability: a systematic review
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