The Spectrum of Lesions and Clinical Results of Arthroscopic Stabilization of Acute Anterior Shoulder Instability

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study is to investigate and analyze accom-panying lesions including injury types of anteroinferior labrum lesion in young and active patients who suffered traumatic anterior shoulder dislocation for the first time.
Meterials and Methods: The study used magnetic resonance angiography (MRA)to 40 patients with acute anterior shoulder dislocation from April 2004 to April 2008, and of those, 36 with abnormal MRA finding were treated with arthroscopy.
Results: There was a total of 25 cases of anteroinferior glenoid labrum lesions. A superior labrum anterior-posterior lesion (SLAP) lesion was observed in 8 cases.
For bony lesions, 22 cases of Hill-sachs lesions, 4 cases of lesions in greater tuberosity fracture of humerus, and 4 cases of loose body were found. For lesions involving rotator cuff, partial articular side rupture was found in 2 cases and 2cases were found to have a complete rupture. Conclusion: Under MRA and arthroscopy performed on patients with acute anterior shoulder dislocation, it was observed to have varying types of anteroinferior labrum lesions such as Perthes,Bankart, ALPSA, and bony Bankart lesion. that MRA is a remar-kably useful tool to classify various lesions in acute anterior dislocation of the shoulder and to make a diagnosis, making it a useful tool to decide a treatment method while consulting patients and their families.

참고문헌 (Reference)

1 Walton J, "The unstable shoulder in the adolescent athlete" 30 : 758-767, 2002

2 Barber FA, "Should first time anterior shoulder dislocations be surgically stabilized?" 19 : 305-309, 2003

3 Rowe CR, "Recurrent transient subluxation of the shoulder" 63 : 863-872, 1981

4 Molina V, "Quantitation of ligament laxity in anterior shoulder instability: an experimental cadaver model" 26 : 349-354, 2004

5 Kirkley A, "Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: longterm evaluation" 21 : 55-63, 2005

6 Itoi E, "Position of immobilization after dislocation of the shoulder. A cadaveric study" 81 : 385-390, 1999

7 Seybold D, "Immobilization in external rotation after primary shoulder dislocation" 77 : 821-826, 2006

8 Cofield RH, "Evaluation and classification of shoulder instability. With special reference to examination under anesthesia" 223 : 32-43, 1987

9 Wheeler JH, "Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes" 5 : 213-217, 1989

10 DeBerardino TM, "Arthroscopic stabilization of acute initial anterior shoulder dislocation: the West Point experience" 5 : 263-271, 1996

11 Arciero RA, "Arthroscopic bioabsorbable tack stabilization of initial anterior shoulder dislocations:a preliminary report" 11 : 410-417, 1995

12 Kim SH, "Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up" 85 : 1511-1518, 2003

13 Arciero RA, "Arthroscopic Bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations" 22 : 589-594, 1994

14 O’Neill DB, "Arthroscopic Bankart repair of anterior detachments of the glenoid labrum. A prospective study" 81 : 1357-1366, 1999

15 Bottoni CR, "A prospective, randomized evaluation of arthroscopic stabilization versus nonoperative treatment in patients with acute, traumatic, first-time shoulder dislocations" 30 : 576-580, 2002