Arthroscopic treatment of post-traumatic shoulder instability in children and adolescents

Abstract

Traumatic dislocation of the shoulder in childhood is rare, accounting for only 0.01% of all injuries in this age class. However, the literature does contain indications that post-traumatic instabilities and redislocations occur with more than average frequency in children and adolescents. This study describes the technique and results of arthroscopic stabilization of the shoulder joint before the completion of growth. Over a period of 4 years, seven patients were treated prior to reaching skeletal maturity. Five patients were treated by means of arthroscopically assisted labral refixation using suture anchor systems. Clinical follow-up was undertaken after between 6 and 48 months using a modified Constant-Murley score. Instabilities, re-dislocations and postoperative impairment of mobility did not occur after arthroscopic treatment, with a score of 92 points. Arthroscopic labral refixation is a reliable, surgical treatment procedure for post-traumatic shoulder instability in adults. This study showed that it can be used successfully in children and young people prior to skeletal maturity. No alteration of the surgical procedure of Bankart repair in adults is necessary. Considerable experience in adult shoulder reconstruction promises excellent results in children and adolescents, too. There is no evidence of growth disturbance or biodegradation associated problems in this group of children and adolescents. Delay of labral refixation until adulthood is therefore not indicated.