Abstract
Background. The recurrence rate of adolescent chronic shoulder instability is approximately 56%–68%. However, this pathology is often missed in childhood and adolescence.Aim. To identify the clinical forms of shoulder joint instability in pediatric patients.Materials and methods. The authors present the data from 57 pediatric patients aged 3−17 years with a total of 61 unstable shoulder joints. All patients were divided into groups according to the form of instability. Traumatic chronic shoulder instability was identified in 40 patients (Bankart and Hill–Sachs injuries). Of these, non-traumatic shoulder instability was diagnose in 17, including five with recurrent dislocation, and spontaneous shoulder dislocation due to dysplasia of glenoid and labrum was diagnosed in 12. Of the 57 patients in the study cohort, 53 underwent surgery. Postoperatively, two patients developed recurrent shoulder dislocation (Andreev–Boichev technique) due type III shoulder dysplasia in the first patient and multidirectional injury in the second.Conclusions. Shoulder joint instability should be considered as the traumatic or non-traumatic form. Treatment decisions should be based on anatomical characteristics that predispose to recurrent dislocation.
Highlights
The recurrence rate of adolescent chronic shoulder instability is approximately 56%–68%. This pathology is often missed in childhood and adolescence
The authors present the data from 57 pediatric patients aged 3−17 years with a total of 61 unstable shoulder joints
All patients were divided into groups according to the form of instability
Summary
Актуальность исследования обусловлена рецидивом привычного вывиха плеча у 56–68 % больных молодого возраста, страдающих хронической нестабильностью плечевого сустава, которая зачастую не диагностирована в детском и подростковом возрасте. Цель исследования: изучить клинические формы нестабильности плечевого сустава у детей. Травматическая форма нестабильности и привычный вывих плеча выявлены у 40 пациентов, определена причина возникновения — травма (повреждение Банкарта и Хила – Сакса). Атравматическая форма нестабильности плечевого сустава выявлена у 17 пациентов, у 3 пациентов диагностирован привычный диспластический вывих плеча, причина — дисплазия суставного отростка лопатки и у 2 пациетов привычный вывих плеча. У 12 пациентов диагностирован произвольный вывих плеча, в восьми случаях при одностороннем поражении причина, вызывающая нестабильность, — дисплазия губы гленоида. Выводы: нестабильность плечевого сустава у детей нужно рассматривать в формате травматической и атравматической формы.
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