Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Shoulder Dislocation ; physiopathology ; therapy ; Shoulder Joint ; injuries

Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations. It may be associated with fractures of the adjacent bones and neurovascular compromise. It should be treated immediately by close reduction. The associated neuropraxia usually recovers with time. Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks. Here, we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.
Adult ; Fractures, Bone ; physiopathology ; therapy ; Humans ; Male ; Shoulder Dislocation ; complications ; physiopathology ; therapy

OBJECTIVETo investigate a manipulating therapy for treatment of anterior shoulder dislocation in elderly.

METHODSFrom October 2011 to June 2012,27 elderly patients with anterior shoulder dislocation were treated by extorsion traction and pushing manipulation with fingers, including 7 males and 20 females aged from 65 to 86 years old with an average of 77. The course of disease ranged from 1 h to 1 d. The shoulder manifested square deformity, Dugus signs showed positive, and X-ray displayed anterior shoulder dislocation. Dugus fixation was applied for and removed external fixation at 3 weeks after operation and carried out shoulder functional exercise. Functional evaluation standard on shoulder joint injuries was used for evaluate clinical outcomes.

RESULTSAll patients were gained reduction for the first time, and followed up at 3 months after operation, no dislocation occurred. According to functional evaluation standard on shoulder joint injuries, 22 cases got an excellent result,2 cases good,and 1 case moderate.

CONCLUSIONExtorsion traction and pushing manipulating therapy for treatment of anterior shoulder dislocation in elderly, which has advantages of simple, convenient, less painful, and can avoid iatrogenic injury, is feasible to widespread.

Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Shoulder Dislocation ; physiopathology ; therapy ; Shoulder Joint ; physiopathology ; Traction ; Treatment Outcome

Shoulder surgeons need to be aware of the critical size of the glenoid or humeral osseous defects seen in patients with anterior shoulder instability, since the considerable size of osseous defect is reported to cause postoperative instability. Biomechanical studies have identified the size of the osseous defect which affects stability. Since engagement always occurs between a Hill-Sachs lesion and the glenoid rim, when considering the critical size of the Hill-Sachs lesion, we have to simultaneously consider the size of the glenoid osseous defect. With the newly developed concept of the glenoid track, we are able to evaluate whether a large Hill-Sachs lesion is an "on-track" or "off-track" lesion, and to consider both osseous defects together. In case of an off-track Hill-Sachs lesion, if the glenoid defect is less than 25%, no treatment is required. In this case, the Latarjet procedure or arthroscopic remplissage procedure can be a treatment option. However, if the glenoid defect is more than 25%, treatment such as bone grafting is required. This will convert an off-track lesion to an on-track lesion. After the bone graft or Latarjet procedure, if the Hill-Sachs lesion persists as off-track, then further treatment is necessitated. In case with an on-track Hill-Sachs lesion and a less than 25% glenoid defect, arthroscopic Bankart repair alone is enough.
Biomechanical Phenomena ; *Glenoid Cavity/injuries/pathology/physiopathology ; Humans ; *Humeral Head/injuries/pathology/physiopathology ; Shoulder Dislocation/physiopathology ; *Shoulder Joint/injuries/pathology/physiopathology

OBJECTIVETo evaluate the posterior and superior compression test (PSCT) and weight-bearing on elbow test (WBE) on the diagnosis of superior labrum anterior to posterior (SLAP) lesion.

METHODSFrom July 2000 to March 2007, 4 clinical tests including O'Brien test, Crank test, PSCT and WBE were randomly performed on 207 patients (209 shoulders). Among the patients, 125 were males and 82 were females with the mean age of 39 years. All the patients underwent arthroscopic treatment by the same doctor. The arthroscopic diagnosis was considered as the golden standard. For each test, the parameters on clinical epidemiology were calculated, and the differences of detection rate between the physical tests and the arthroscopic examination were compared.

RESULTSThe parameters on clinical epidemiology of O'Brien test, Crank test, PSCT and WBE were comparable. The difference of detection rate between the physical tests and the arthroscopic examination was not statistically significant (P > 0.05). The detection rates of PSCT and WEB in the group of injury of posterior and superior labrum were statistically higher than the group of injury of anterior and superior labrum. The detection rate of PSCT in the group of simple SLAP lesion was relatively higher.

CONCLUSIONSCompared with O'Brien test and Crank test, the new PSCT and WBE have not only comparable clinical value in the diagnosis of SLAP lesion, but also the advantage in predicting the location of SLAP lesion. The detection rate of PSCT in the group of simple SLAP lesion is relatively higher, but the mechanism is to be determined.

Adolescent ; Adult ; Aged ; Arthroscopy ; Elbow Joint ; injuries ; physiopathology ; Exercise Test ; methods ; Female ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; diagnosis ; physiopathology ; Shoulder Joint ; injuries ; physiopathology ; Weight-Bearing

Posterolateral rotatory instability of the elbow describes a condition that radial head subluxation or dislocation occurs when forearm rotates externally in relation to humerus. It is difficult to diagnose and treat. We reported a typical case which was confirmed by physical examination and MR images. Ligamentous insufficiency was confirmed under direct vision, and was reconstructed with triceps fascia as described by Gong et al with slight modification. Regain of full function was achieved one year after surgery.
Adult ; Elbow Joint ; physiopathology ; Female ; Humans ; Joint Instability ; complications ; diagnosis ; physiopathology ; surgery ; Magnetic Resonance Imaging ; Shoulder Dislocation ; complications

Adult ; Elbow Joint ; injuries ; Female ; Humans ; Musculoskeletal Manipulations ; Shoulder Dislocation ; diagnostic imaging ; pathology ; physiopathology ; therapy ; Shoulder Fractures ; diagnostic imaging ; pathology ; physiopathology ; therapy ; Tomography, X-Ray Computed

OBJECTIVETo compare the therapeutic effect difference between electroacupuncture combined with rehabilitation techniques and simple rehabilitation techniques for treatment of the shoulder subluxation after stroke.

METHODSSixty cases of shoulder subluxation patients were divided into an acupuncture combined with rehabilitation group (30 cases) and a rehabilitation group (30 cases). The acupuncture combined with rehabilitation group was treated with electroacupuncture at Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) etc. combined with rehabilitation treatment, the rehabilitation group was treated with rehabilitation only. The therapeutic effects were evaluated and the pain score of the shoulder joint, passive range of motion of shoulder joint, the muscle strength of middle group of the deltoid and the function grade of the upper limbs motion of the two groups were evaluated before and after treatment.

RESULTSThe acupuncture combined with rehabilitation group was superior to that of the rehabilitation group in pain score of the shoulder joint, passive range of motion of shoulder joint, the muscle strength of middle group of the deltoid and the function grade of the upper limbs motion with significant differences between the two groups (all P<0.05); the total effective rate of 93. 3% in the acupuncture combined with rehabilitation group was superior to that of 73.3% in the rehabilitation group (P<0.05).

CONCLUSIONThe therapy of electroacupuncture combined with rehabilitation techniques can act a good regulating role on muscle strength and the muscular tension of shoulder joint and the muscles around the scapula through many steps, and can effectively improve the shoulder subluxation.

Acupuncture Points ; Adult ; Aged ; Electroacupuncture ; Humans ; Male ; Middle Aged ; Muscle Strength ; Shoulder Dislocation ; physiopathology ; rehabilitation ; therapy ; Shoulder Joint ; physiopathology ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo compare the efficacy differences of electroacupuncture (EA) with intermittent wave, disperse-dense wave and continuous wave combined with rehabilitation therapy for post-stroke shoulder subluxation in order to provide clinical evidence for selection of electroacupuncture wave.

METHODSSeventy-five cases of shoulder subluxation were randomly divided into an intermittent wave (IW) group, a disperse-dense wave (DW) group and a continuous wave (CW) group, 25 cases in each one. Based on regular treatment including blood pressure and sugar control, EA and rehabilitation therapy were given in three groups. With EA at Jianqian (Extra), Taijian(Extra), Binao (LI 14), Jianzhong (Extra), Jianzhen (SI 9), Naoshu (SI 10), Jianwaishu (SI 14) and Bingfeng (SI 12), IW group was treated with intermittent wave with a frequency of 15 Hz, DW group was treated with disperse-dense wave with a frequency of 2 Hz/15 Hz and CW group was treated with continuous wave with a frequency of 15 Hz. The EA treatment was given for 20 min, once a day, six times a week and totally for 4 weeks. The Fugl-Meyer score and Barthel index score were used for assessment of function recovery before and after treatment respectively, also the efficacy of three groups was compared.

RESULTSThe total effective rate was 96.0% (24/25) in the IW group, which was superior to 68.0% (17/ 25) in the DW group and 64.0% (16/25) in the CW group (both P < 0.05). After the treatment, Fugl-Meyer score and Barthel index score in the three groups were obviously improved (all P < 0.05), which was most significant in the IW group (all P < 0.01).

CONCLUSIONElectroacupuncture with intermittent wave combined with rehabilitation therapy has superior effect to disperse-dense wave and continuous wave on the treatment of post-stroke shoulder subluxation, which could effectively improve shoulder subluxation and promote shoulder function recovery.

Aged ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Shoulder ; physiopathology ; Shoulder Dislocation ; etiology ; rehabilitation ; therapy ; Stroke ; complications ; Treatment Outcome

Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.
Accidental Falls ; Aged ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Range of Motion, Articular ; Recurrence ; *Rotator Cuff Injuries/diagnosis/diagnostic imaging/physiopathology ; *Shoulder/diagnostic imaging/pathology/physiopathology ; *Shoulder Dislocation/diagnosis/diagnostic imaging/physiopathology