1/99. brachial plexus lesions complicating anterior fracture-dislocation of the shoulder joint.Four cases of brachial plexus lesions caused by anterior fracture-dislocation of the shoulder are reported. The incidence, mechanism of injury and prognosis are reviewed.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/99. Bilateral anterior shoulder fracture-dislocation. A case report and a review of the literature.We report an unusual case of bilateral anterior shoulder dislocation following trauma. Previously reported cases were either of bilateral dislocations or bilateral fracture dislocations. In our case the patient suffered bilateral anterior dislocation with a three part fracture dislocation on the right. A review of the literature is presented.- - - - - - - - - - ranking = 1.2keywords = fracture (Clic here for more details about this article) |
3/99. CT imaging and three-dimensional reconstructions of shoulders with anterior glenohumeral instability.Glenohumeral instability is a common occurrence following anterior dislocation of the shoulder joint, particularly in young men. The bony abnormalities encountered in patients with glenohumeral instability can be difficult to detect with conventional radiography, even with special views. The aim of our study was to evaluate the bony abnormalities associated with glenohumeral instability using CT imaging with 3-D reconstruction images. We scanned 11 patients with glenohumeral instability, one with bilateral symptoms; 10 were male, one female, and their ages ranged from 18-66 years. Contiguous 3 mm axial slices of the glenohumeral joint were taken at 2 mm intervals using a Siemens Somatom CT scanner. In the 12 shoulders imaged, we identified four main abnormalities. A humeral-head defect or Hill-Sachs deformity was seen in 83% cases, fractures of the anterior glenoid rim in 50%, periosteal new bone formation secondary to capsular stripping in 42%, and loose bone fragments in 25%. Manipulation of the 3-D images enabled the abnormalities to be well seen in all cases, giving a graphic visualization of the joint, and only two 3-D images were needed to demonstrate all the necessary information. We feel that CT is the imaging modality most likely to show all the bone abnormalities associated with glenohumeral instability. These bony changes may lead to the correct inference of soft tissue abnormalities making more invasive examinations such as arthrography unnecessary.- - - - - - - - - - ranking = 0.2keywords = fracture (Clic here for more details about this article) |
4/99. Arthroscopic treatment of acute traumatic anterior glenohumeral dislocation and greater tuberosity fracture.We present a case and a description of treatment of an anterior dislocation of the shoulder with a greater tuberosity fracture. Both the Bankart lesion and the tuberosity fracture were repaired using arthroscopic techniques.- - - - - - - - - - ranking = 1.2keywords = fracture (Clic here for more details about this article) |
5/99. An operative technique for recurrent shoulder dislocations in older patients.Recurrent anterior shoulder dislocation in the elderly is not as exceptional as it was once thought to be. That anterior shoulder dislocation in older patients is caused by a rotator cuff tear through the posterior mechanism is well accepted. However, in the subset of patients who have multiple recurrent or intractable dislocations develop, there may be combined pathologic conditions at work: large or massive rotator cuff tears together with anterior capsulolabral injuries such as a Bankart lesion or fracture of the glenoid rim. These patients have multiple recurrences because of disruption of both the anterior and the posterior stability mechanisms. We suggest a procedure that provides anterior stabilization with the capsular shift technique and that is supplemented by Bankart repair as necessary. The capsule transfer is performed superiorly and posteriorly to close the defect in the cuff. In this way a capsulodesis effect can be achieved that displaces the humeral head downward and produces active centering of the head in the course of abduction. Use of only the anterior capsule for the shift, and not the subscapularis tendon, does not compromise subscapularis function. Between 1990 and 1996, we used this technique to treat 16 patients older than 55 years of age with multiple recurrent anterior shoulder dislocation and massive rotator cuff tear. We report the results for the first 10 patients with a minimum follow-up of 2 years (range 2 to 7 years) and an average follow-up of 52 months. There were 7 excellent results, 2 good results, and 1 fair result according to the Rowe criteria. None of the patients had a recurrence of the dislocation. All the patients regained full or functional range of motion with stable shoulders, and most of them could perform activities of daily living without limitation. The average Constant score was 83%. This procedure appears to be successful in treating older patients with recurrent shoulder dislocation.- - - - - - - - - - ranking = 0.2keywords = fracture (Clic here for more details about this article) |
6/99. Irreducible acute anterior dislocation of the shoulder caused by interposed fragment of the anterior glenoid rim.Failure of manipulative reduction of acute anterior dislocation of the shoulder is extremely rare. A 55-year-old man dislocated his right shoulder when he fell heavily. Initial radiographs and computed tomographs demonstrated an anterior dislocation with fracture of the glenoid rim. Several attempts at closed reduction were unsuccessful. At the time of open reduction, the cause of failure was found to be interposition of a fragment of the anterior inferior glenoid rim in the joint. To prevent redislocation, the fragment was held in place by two Herbert mini bone screws after anatomic reduction, and the ruptured subscapularis was reattached to the lesser tuberosity. Two and a half months after surgery, the shoulder was stable with full range of motion. To the best of our knowledge, this is the first reported case of interposition of a fracture-fragment of the anterior inferior glenoid rim causing failure of reduction.- - - - - - - - - - ranking = 0.4keywords = fracture (Clic here for more details about this article) |
7/99. Posterior dislocation fractures of the shoulder in seizure disorders--two case reports and a review of literature.We present two patients with complaints of shoulder pain after an epileptic seizure. Both patients had a posterior dislocation fracture of the shoulder. After reviewing the literature the following conclusions can be drawn: (1) A posterior shoulder dislocation fracture is rare. (2) One should not underestimate the muscular forces in seizure disorders and be alert for dislocation fractures of the shoulder and/or other joints. (3) The diagnosis is frequently missed, but an axillary radiograph or a CT scan always reveals the fracture.- - - - - - - - - - ranking = 1.6keywords = fracture (Clic here for more details about this article) |
8/99. Proximal humerus fracture.A thirty-five-year-old man who fell from a tree is admitted to the emergency department with the x-rays shown below. physical examination reveals that the patient is neurologically intact and has good pulses. Management of this case is described in the following opinions.- - - - - - - - - - ranking = 0.8keywords = fracture (Clic here for more details about this article) |
9/99. Triple "E" syndrome: bilateral locked posterior fracture dislocation of the shoulders.Bilateral locked posterior fracture dislocation of the shoulders is one of the least common injuries of the shoulder, and this injury has been suggested to be pathognomonic of seizures when diagnosed in the absence of trauma. The authors present a case of idiopathic bilateral locked posterior fracture dislocations of the shoulder, along with a review of the medical literature. The authors also present the "triple E syndrome," describing the possible etiologies of this injury: epilepsy (or any convulsive seizure), electrocution, or extreme trauma.- - - - - - - - - - ranking = 1.2keywords = fracture (Clic here for more details about this article) |
10/99. Ipsilateral dislocation of the shoulder and elbow.Ipsilateral dislocation of shoulder and elbow joints is a rare injury. Only 2 such cases have been reported in the English literature. We report a case of a 35-year-old man involved in a road traffic accident under the influence of alcohol. He sustained posterior left elbow and anterior left shoulder dislocation with minimally displaced greater tuberosity fracture. He also had partial median nerve palsy. Under intramuscular pethidine and intravenous diazepam, close reduction of elbow followed by shoulder was carried out. At 2 months, median nerve function returned to normal. At 3 months, almost full elbow and shoulder joint movement returned. Although rare and complex, this ipsilateral injury can be treated conservatively.- - - - - - - - - - ranking = 0.2keywords = fracture (Clic here for more details about this article) |
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