Glenohumeral Instability

Barnes, Leslie Fink; Parsons, Bradford O.; Lippitt, Steven B.; Flatow, Evan L.; Matsen, Frederick A.

doi:10.1016/b978-0-323-29731-8.00013-1

Cited by 4 publications

(5 citation statements)

References 494 publications

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“…2 Present Address: Departamento de Cirugía, Ciencias Sanitarias Y Medicosociales, Universidad de Alcalá de Henares, Madrid, Spain. 3 Área De Traumatología y Ortopedia, Universidad CEU San Pablo, Madrid, Spain. 4 Radiology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain.…”

Section: Discussionunclassified

“…After CT confirmation of the anterior dislocation and the absence of associated fractures, reduction of the shoulder was attempted using the following protocol: First, an intraarticular injection of 10 cm 3 of mepivacaine 1% was performed through a lateral approach [18]. Then a reduction attempt was performed by the orthopaedic surgery resident using the traction/contra-traction manoeuvre [3], the Milch [18] or the FARES method [20]. If, after two attempts, reduction was not obtained, the participant was brought to the surgical theatre and reduction was obtained under deep sedation with propofol (initial bolus of 2 mg/kg, followed by perfusion of 6 mg/kg/h).…”

Section: Methodsmentioning

confidence: 99%

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The size of the Hill Sachs defect increases during reduction of a first time shoulder dislocation in older adults: a pilot study in 20 cases

Ruiz Ibán,

Pérez Expósito,

Vicente Bártulos

et al. 2023

J. exp. orthop.

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Purpose To evaluate if the size of Humeral Hill-Sachs Defects (HSDs) increases during reduction in the emergency department (ED) in subjects that have a first-time anterior shoulder dislocation. Methods Subjects more than 18 years old presenting to the ED a first-time anterior shoulder dislocation were included. A computed tomography was performed prior to any reduction attempt (Pre-CT). The shoulder was reduced in the emergency room with intraarticular lidocaine; if two attempts failed, the shoulder was reduced under anaesthesia. A second CT was performed after reduction of the shoulder (Post-CT). CT were evaluated using the Osirix software. A 3-dimensional reconstruction of the humeral head was performed and the maximum width of the humeral defect, maximum depth of the humeral defect and total volume of the humeral defect were measured. The relative increase in size was calculated. Results Twenty subjects were included in the study. All subjects presented HSDs in the Pre-CT that had a width of a median of 9.9(interquartile range:2.9)mm, a depth of 7.0(3.0]mm and a volume of 355(333)mm2. The HSD in the Post-CT had a width of 10.9(3.0)mm (an increase of 7.23[8.5]%, significant differences, p = 0.0001) a depth of 7.2(2.7)mm (an increase of 9.93[20.7]%, significant differences, p < 0.0001) and a volume of 469(271) mm2 (an increase of 27.5[26.9]%, significant differences, p < 0.0001). There were size increases larger than 25% in 15/20 (75%) of subjects. Conclusion Standard reduction manoeuvres performed in a first-time anterior shoulder dislocation increase the size of the HSD. This increase in size is larger than 25% in four out of five cases. Level of evidence IV, prospective cases series study.

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Section: Discussionunclassified

Section: Methodsmentioning

confidence: 99%

The size of the Hill Sachs defect increases during reduction of a first time shoulder dislocation in older adults: a pilot study in 20 cases

Ruiz Ibán,

Pérez Expósito,

Vicente Bártulos

et al. 2023

J. exp. orthop.

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“…The glenohumeral ligaments are primarily located in the superior, anterior and inferior aspects of the joint. Unlike ligaments in other joint types that have an isometric articulation (such as those regularly found supporting synovial hinge joints), the glenohumeral ligaments are lax in most joint positions and augment the humeral head in joint motion particularly in extreme motions (Barnes et al, 2018). This section will explore these ligaments and their relationship to the glenoid labrum.…”

Section: Associated Structures Related To the Glenoid Labrummentioning

confidence: 99%

“…When present as a stand‐alone structure (e.g., not a Buford complex), the middle glenohumeral ligament was found to be under tension in cadaveric specimens during abduction (up to 45°), particularly when accompanied by external rotation (Barnes et al, 2018; Felli et al, 2012). SLAP lesions have been associated with middle glenohumeral ligament variations, in which the SLAP lesion extends anteriorly into the area of the middle glenohumeral ligament (Beltran et al, 2002).…”

Section: Associated Structures Related To the Glenoid Labrummentioning

confidence: 99%

“…The glenohumeral joint is a synovial, ball‐and‐socket joint, which is formed by the humeral head laterally and the glenoid fossa of the scapula medially. By possessing an extensive range of movements, the glenohumeral joint sacrifices stability for greater mobility, especially when compared with other large synovial joints, such as the hip, elbow and knee joints (Barnes et al, 2018; Jobe et al, 2018; Lippitt & Matsen, 1993). However, the glenohumeral joint is provided with some semblance of stability by a combination of ligaments, a fibrous joint capsule and surrounding skeletal muscles (Felli et al, 2012; Moore et al, 2015; Warner et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

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Anatomical, functional and biomechanical review of the glenoid labrum

et al. 2021

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The glenohumeral joint is the most mobile joint in the human skeleton, supported by both active and passive stabilisers. As one of the passive stabilisers, the glenoid labrum has increasingly been recognised to play an important role in stability of the glenohumeral joint, acting to maintain intraarticular pressure, centralise the humeral head and contribute to concavity‐compression stability. Several studies have investigated the macro‐ and micro‐anatomical features of the labrum as well as its biomechanical function. However, in order to better understand the role of the labrum and its mechanics, a comprehensive anatomical, functional and biomechanical review of these studies is needed. Therefore, this article reviews the current literature detailing anatomical descriptions of the glenoid labrum, with an emphasis on its function(s) and biomechanics, as well as its interaction with neighbouring structures. The intimate relationship between the labrum and the surrounding structures was found to be important in glenohumeral stability, which owes further investigation into the microanatomy of labrum to better understand this relationship.

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