Glenohumerale Luxation: Verletzungsmuster und Kombinationsverletzungen

Translated title of the contribution: Glenohumeral dislocation: Injury patterns and combination injuries

R. Flückiger, S. Raniga, B. K. Moor, M. A. Zumstein*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Almost 90 % of first time shoulder dislocations are associated with other injuries involving the glenohumeral joint complex. It is important to make an accurate diagnosis even if this does not always influence the choice of an appropriate therapy. Content: In the acute setting it is imperative that X-ray imaging is performed before and after repositioning in at least two planes, i.e. anteroposterior (AP), Neer and if possible axial views. Fracture dislocations must not be overlooked as repositioning maneuvers can lead to secondary displacement or complete displacement of a fracture. If there is any evidence of an unstable glenoid fracture, humeral fracture or combined osseous lesions, they should be immediately treated with open reduction and internal fixation. Patients with an incongruent glenohumeral articulation or who suffer from recurrent instability require a surgical intervention. In recurrent shoulder instability with evidence of osseous lesions arthrography computed tomography (arthro-CT) is the most valuable investigation. Injuries to the capsulolabral complex and rotator cuff can be diagnosed with this modality but arthrography magnetic resonance imaging (arthro-MRI) can provide greater details with respect to rotator cuff lesions. Discussion: Acute large or massive rotator cuff lesions require semi-urgent repair. Off-track Hill-Sachs lesions with medial extension should be addressed with a remplissage or bone grafting. The long-term results of a Latarjet procedure at 25-year follow-up showed a very low redislocation rate (< 4 %), good external rotation, very high patient satisfaction and a rate of degenerative changes comparable with the natural development of first time shoulder dislocations without recurrent instability.

Translated title of the contributionGlenohumeral dislocation: Injury patterns and combination injuries
Original languageGerman
Pages (from-to)292-300
Number of pages9
JournalArthroskopie
Volume28
Issue number4
DOIs
Publication statusPublished - Oct 8 2015
Externally publishedYes

Keywords

  • Glenoid rim fracture
  • Hill Sachs lesion
  • Rotator cuff tear
  • Shoulder dislocation
  • Shoulder stabilization

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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