Instability Flashcards
What does instability of the shoulder involve?
Painful abnormal translational movement or subluxation/recurrent dislocations
What are the two patterns of shoulder instability?
Traumatic and atraumatic
What type of shoulder dislocation is a traumatic one most likely to be?
Anterior
After reduction of a traumatic anterior shoulder dislocation, what may help it settle?
Rest and strengthening physiotherapy
What happens in shoulders which do not stabilise after a 1st traumatic dislocation?
Recurrent dislocations/subluxations, often with minimal force
What is the best predictor of the chance of further dislocation after a first traumatic dislocation?
Age
Patients < 20 are how likely to have a 2nd shoulder dislocation after the first traumatic one?
80%
Patients > 30 are how likely to have a 2nd shoulder dislocation after the first traumatic one?
20%
In recurrent shoulder dislocations (traumatic group), what is the treatment?
Bankhart repair- stabilises the shoulder by reattaching the labrum and capsule to the anterior glenoid which was torn the first time
Who gets atraumatic shoulder instability?
Ligamentous laxity- idiopathic, Ehlor’s Danlos, Marfan’s
People who are predisposed to atraumatic shoulder dislocations get pain from recurrent dislocations in what direction?
Multidirectional (anterior, posterior, inferior)
Why is treatment difficult for atraumatic shoulder dislocations in predisposed individuals?
Soft tissue procedures probably won’t work
What is it known as in anterior dislocation if the labrum commonly detaches?
Bankhart lesion
What nerve is most commonly associated with shoulder dislocations since it is very close to the humerus?
Axillary nerve
What structures can a shoulder dislocation press on?
The brachial plexus +/- axillary artery
