Introduction: Bilateral inferior shoulder dislocation is rare; but the dislocation is almost always reducible by closed means. We present a unique case of irreducible bilateral inferior shoulder dislocation.
Presentation Of Case: A 35-year old male fell down from height. Direct axial loading while both shoulders were fully abducted resulted in bilateral inferior shoulder dislocation. All attempts of closed reduction failed. Open reduction revealed that the cause of irreducibility was the entrapment of the humeral head in a button-hole through the inferior joint capsule and the surrounding soft tissue envelope. At 6 months, there was almost full range of motion and no pain.
Discussion: The direct axial loading resulted in a narrow defect in the inferior joint capsule/soft tissue envelope; and this may have led to button-hole entrapment of the dislocated humeral head and irreducibility. Open reduction required widening of the button-hole while protecting the axillary neurovascular bundle.
Conclusion: We present a rare case of bilateral irreducible inferior shoulder dislocation. We highlight the pathomechanics of irreducibility: button-hole entrapment of the humeral head. We emphasize technical tips during open reduction such as widening of the button-hole and protection of the axillary neurovascular bundle. The outcome is good although some limitation of shoulder abduction is to be expected.
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http://dx.doi.org/10.1016/j.ijscr.2017.01.025 | DOI Listing |
J Shoulder Elbow Surg
January 2025
Investigation Performed at the University of Washington, Department of Orthopaedic Surgery and Sports Medicine, Seattle, WA, USA. Electronic address:
Background: While stress shielding and adaptive bone changes around the humeral component are often observed after shoulder arthroplasty, the potential causative factors and clinical significance of these findings at mid-term follow-up have not been well elucidated. The purpose of this study was to investigate the frequency, patterns and clinical significance of radiographic findings around the humeral component of total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) at minimum 4-year follow-up.
Methods: The 6-week and minimum 4-year radiographs of patients who underwent HA and TSA were evaluated for filling ratios, changes in the humeral bone surrounding the component, and component shift or subsidence.
Curr Rev Musculoskelet Med
January 2025
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Purpose Of Review: With the growing popularity and broadening indications for Reverse Shoulder Arthroplasty (RSA), increasing modularity in design and adjustments to each component can enhance postoperative range of motion (ROM), thus expanding treatment capabilities. This review outlines the advancements developed to optimize ROM through modifications in glenoid and humeral components and the integration of computational tools for surgical planning.
Recent Findings: Enhancements in glenoid component design aim to mitigate complications like scapular notching and improve ROM, particularly in abduction and external rotation.
Arthrosc Sports Med Rehabil
December 2024
Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
Purpose: To evaluate the relationship between preoperative whole-joint imaging evaluation of the knee with patient-reported outcome (PRO) measures after cartilage restoration surgery (mosaicplasty, osteochondral allograft transplantation, matrix autologous chondrocyte implantation).
Methods: We retrospectively evaluated patients who underwent knee articular cartilage restoration at our institution from 2014 to 2020. The patients' knee magnetic resonance imaging (MRI) was evaluated with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and semiquantitative synovial inflammation imaging biomarkers of the preoperative MRI.
JBJS Essent Surg Tech
January 2025
Shoulder and Elbow Service, Florida Orthopaedic Institute, Tampa, Florida.
Background: The incidence of revision shoulder arthroplasty continues to rise, and infection is a common indication for revision surgery. Treatment of periprosthetic joint infection (PJI) in the shoulder remains a controversial topic, with the literature reporting varying methodologies, including the use of debridement and implant retention, single-stage and 2-stage surgeries, antibiotic spacers, and resection arthroplasty. Single-stage revision has been shown to have a low rate of recurrent infection, making it more favorable because it precludes the morbidity of a 2-stage operation.
View Article and Find Full Text PDFBankart lesions, or anterior-inferior glenoid labral tears, are diagnostically challenging on standard MRIs due to their subtle imaging features-often necessitating invasive MRI arthrograms (MRAs). This study develops deep learning (DL) models to detect Bankart lesions on both standard MRIs and MRAs, aiming to improve diagnostic accuracy and reduce reliance on MRAs. We curated a dataset of 586 shoulder MRIs (335 standard, 251 MRAs) from 558 patients who underwent arthroscopy.
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