Purpose: A change in the strategy for treating primary anterior traumatic dislocation of the shoulder has occurred. To date, brief fixation of internal rotation via a Gilchrist bandage has been used. Depending on the patient's age, a redislocation is seen in up to 90 % of cases. This is due to healing of the internally rotated labrum-ligament tear in an incorrect position. In the case of external rotation of the humerus, better repositioning of the labrum ligament complex is achieved. Using MRI of the shoulder in external rotation, the extent of the improved labrum-ligament adjustment can be documented, and the indication of immobilization of the shoulder in external rotation can be derived. The aim of this investigation is to describe the degree of position changing of the labrum-ligament tear in internal und external rotation.
Materials And Methods: 10 patients (9 male, 1 female, mean age 30.4 years, range 15 - 43 years) with a primary anterior dislocation of the shoulder without hyper laxity of the contra lateral side and labrum-ligament lesion substantiated by MRI were investigated using a standard shoulder MRI protocol (PD-TSE axial fs, PD-TSE coronar fs, T2-TSE sagittal, T1-TSE coronar) by an axial PD-TSE sequence in internal and external rotation. The dislocation and separation of the anterior labrum-ligament complex were measured. The shoulders were immobilized in 10 degrees external rotation for 3 weeks. After 6 weeks a shoulder MRI in internal rotation was performed.
Results: In all patients there was a significantly better position of the labrum-ligament complex of the inferior rim in external rotation, because of the tension of the ventral capsule and the subscapular muscle. In the initial investigation, the separation of the labrum-ligament complex in internal rotation was 0.44 +/- 0.27 mm and the dislocation was 0.45 +/- 0.33 mm. In external rotation the separation was 0.01 +/- 0.19 mm and the dislocation was - 0.08 +/- 0.28 mm. After 6 weeks of immobilization in 10 degrees external rotation, the separation of the labrum was - 0.10 +/- 0.14 mm and the dislocation was - 0.23 +/- 0.21 mm.
Conclusion: In anterior labrum-ligament tears, the axial MRI of the shoulder in external rotation demonstrates a more physiologic position of the glenoid. This may indicate an immobilization of the shoulder in external rotation, which results in a more anatomical healing of the glenoidal tear. Thus, in the case of labrum-ligament tears, MRI in external rotation is becoming indispensable.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1055/s-2006-926476 | DOI Listing |
Arch Bone Jt Surg
January 2024
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Objectives: This study aimed to introduce a new arthroscopic method for reconstructing the popliteus tendon (PT). This minimally invasive technique is performed through the posterolateral corner (PLC) of the knee, which can reconstruct the posterolateral rotary instability (PLRI) of the knee.
Methods: Thirty-nine patients (8 females, 31 males) with PLC injury and normal knee alignment underwent arthroscopic PT reconstruction.
Arch Bone Jt Surg
January 2024
Department of Orthopedic Surgery, 5th Azar hospital, Golestan University of Medical Sciences, Gorgan, Iran.
Objectives: Anterior shoulder instability with minimal glenoid bone loss has several options for Bankart repair. We aimed to evaluate the results of a modified technique using two anchors with double and single loaded suture (three stitches in total) in arthroscopic Bankart surgery.
Methods: Thirty-eight patients underwent arthroscopic Bankart surgery and were assessed after an average 40 months follow-up.
JB JS Open Access
January 2025
Department of Orthopaedic Surgery, University Hospital, Shiga University of Medical Science, Shiga, Japan.
Background: Although a certain degree of tension in bridging sutures is required for proper tendon healing following suture-bridge rotator cuff repair, excessive suture tension may be detrimental to tendon healing. This study aimed to investigate the effects of bridging suture tension on clinical outcomes and tendon healing. We hypothesized that fixed, low tension of the bridging sutures would improve the tendon healing rate and clinical outcomes compared with maximum manual tensioning.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Department of Orthopaedic Surgery, University Hospital centre (Saint Etienne), Avenue Albert Raimond, Saint-priest-en-Jarez, 42270, France.
Introduction: Total knee arthroplasty (TKA) in valgus knees is challenging. Optimal ligament balance, implant neutral or moderate valgus alignment are crucial but conventional instrumentations usually lead to outliers. Robotic arm assisted TKA (RATKA) advantages could answer this challenge.
View Article and Find Full Text PDFZhongguo Gu Shang
January 2025
Unit 66322 of the People's Liberation Army, Beijing 100000, China.
Objective: Meta-analysis of the clinical efficacy of plate and external fixator fixation in the treatment of AO-C type distal radius fractures.
Methods: PubMed, Embase, Cochrane Medical Library, Web of Science, CNKI, Wanfang, VIP and SinoMed databases were searched for all literature on randomized controlled clinical trials of AO-C distal radius fractures. The search time limits were from each database.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!