Shoulder instability in adolescents: Indications for surgery. Case report
DOI:
https://doi.org/10.1016/j.rccot.2021.07.004Keywords:
Joint Instability, Shoulder dislocation, Glenohumeral subluxation, Evidence level: IVAbstract
Shoulder instability is a frequent condition in people involved in sport activities of high-physical demand. Due to their anatomical features, adolescents are at greater risk of recurrence after a first episode of shoulder dislocation. Male gender, age and participation in high-impact sport activities are the main risk factors for recurrence. We report the case of a cheerleader teenager with anterior shoulder instability with favorable evolution after open stabilization complemented by a review of the state of the art of the therapeutic approaches of recurrent shoulder instability in adolescents.
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References
Lazaro LE, Cordasco FA. Physical exam of the adolescent shoulder: Tips for evaluating and diagnosing common shoulder disorders in the adolescent athlete. Curr Opin Pediatr. 2017;29:70-9.
Goldberg AS, Moroz L, Smith A, Ganley T. Injury Surveillance in Young Athletes. Sport Med. 2007;37:265-78. Available from: http://link.springer.com/10.2165/00007256-200737030-00005.
Longo UG, Van Der Linde JA, Loppini M, Coco V, Poolman RW, Denaro V. Surgical Versus Nonoperative Treatment in Patients Up to 18 Years Old with Traumatic Shoulder Instability: A Systematic Review and Quantitative Synthesis of the Literature. Arthrosc - J Arthrosc Relat Surg. 2016;32:944-52, http://dx.doi.org/10.1016/j.arthro.2015.10.020.
Chapus V, Rochcongar G, Pineau V, Salle de Chou, Hulet C. Ten-year follow-up of acute arthroscopic Bankart repair for initial anterior shoulder dislocation in young patients. Orthop Traumatol Surg Res. 2015;101:889-93, http://dx.doi.org/10.1016/j.otsr.201509029.
Kraus R, Pavlidis T, Heiss C, Kilian O, Schnettler R. Arthroscopic treatment of post-traumatic shoulder instability in children and adolescents. Knee Surgery, Sport Traumatol Arthrosc. 2010;18:1738-41.
Ayres HB, Winters B, Nuttall C, Ayres HB. Age-appropriate Post-reduction Care of Anterior Shoulder Dislocation [Internet]. Brigham Young University;. 2015. Available from: https://scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=1144&context=studentpub.
Zacchilli MA, Owens BD. Epidemiology of Shoulder Dislocations Presenting to Emergency Departments in the United States. J Bone Jt Surgery Am. 2010;92:542-9.
Tobler DA, Fernandez N, Etcheverry DA. Inestabilidad Posterior en Edad Pediátrica. Abordaje Artroscópico. Artroscopia. 2014;21:19-22.
Lin KM, James EW, Spitzer E, Fabricant PD. Pediatric and adolescent anterior shoulder instability: Clinical management of first-time dislocators. Curr Opin Pediatr. 2018;30:49-56.
Robinson CM. Functional Outcome and Risk of Recurrent Instability After Primary Traumatic Anterior Shoulder Dislocation in Young Patients. J Bone Jt Surg [Internet]. 2006;88:2326, http://dx.doi.org/10.2106/JBJS.E.01327.
Olds M, Donaldson K, Ellis R, Kersten P. In children 18 years and under, what promotes recurrent shoulder instability after traumatic anterior shoulder dislocation? A systematic review and meta-analysis of risk factors. Br J Sports Med. 2016;50:1135-41.
Leroux T, Wasserstein D, Veillette C, Khoshbin A, Henry P, Chahal J, et al. Epidemiology of Primary Anterior Shoulder Dislocation Requiring Closed Reduction in Ontario. Canada. Am J Sports Med. 2014;42:442-50, http://dx.doi.org/10.1177/0363546513510391.
Deitch J, Mehlman CT, Foad SL, Obbehat A, Mallory M. Traumatic anterior shoulder dislocation in adolescents. Am J Sports Med. 2003;31:758-63, doi: http://www.ncbi.nlm.nih.gov/pubmed/12975198.
Anakwenze OA, Huffman GR. Evaluation and treatment of shoulder instability. Phys Sports med. 2011;39:149-57.
Handoll H, Al-maiyah M. Surgical versus non-surgical treatment for acute anterior shoulder dislocation. Cochrane Database Syst Rev. 2004:1-25.
Gigis I, Heikenfeld R, Kapinas A, Listringhaus R, Godolias G. Arthroscopic versus conservative treatment of first anterior dislocation of the shoulder in adolescents. J Pediatr Orthop. 2014;34:421-5.
Godin J, Sekiya JK. Systematic review of rehabilitation versus operative stabilization for the treatment of first-time anterior shoulder dislocations. Sports Health. 2010;2:156-65.
Longo UG, Van Der Linde JA, Loppini M, Coco V, Poolman RW, Denaro V. Surgical Versus Nonoperative Treatment in Patients Up to 18 Years Old with Traumatic Shoulder Instability: A Systematic Review and Quantitative Synthesis of the Literature. Arthrosc - J Arthrosc Relat Surg. 2016;32:944-52.
Roberts SB, Beattie N, McNiven ND, Robinson CM. The natural history of primary anterior dislocation of the glenohumeral joint in adolescence. Bone Jt J. 2015;97-B:520-6.
Kane P, Bifano SM, Dodson CC, Freedman KB. Approach to the treatment of primary anterior shoulder dislocation: A review. Phys Sportsmed. 2015;43:54-64, http://dx.doi.org/10.1080/00913847.2015.1001713.
Brophy RH, Marx RG. The Treatment of Traumatic Anterior Instability of the Shoulder: Nonoperative and Surgical Treatment. Arthrosc - J Arthrosc Relat Surg. 2009;25:298-304, http://dx.doi.org/10.1016/j.arthro.2008.12.007.
Kirkley A, Werstine R, Ratjek A, Griffin S. Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: Long-term evaluation. Arthrosc - J Arthrosc Relat Surg. 2005;21:55-63.
Kirkley A, Griffin S, Richrads C, Miniaci A, Mohtadi N. Traumatic Anterior Dislocations of the Shoulder. Arthrosc J Arthrosc Relat Surg. 1999;15:507-14.
Cordischi K, Li X, Busconi B. Intermediate Outcomes After Primary Traumatic Anterior Shoulder Dislocation in Skeletally Immature Patients Aged 10 to 13 Years. Orthopedics. 2009;32:686-90, doi:http://www.healio.com/doiresolver?doi=10.3928/01477447-20090728-34.
Postacchini F, Gumina S, Cinotti G. Anterior shoulder dislocation in adolescents. J Shoulder Elb Surg. 2000;9:470-4, doi:https://linkinghub.elsevier.com/retrieve/pii/S105827460003799X.
Walton J, Paxinos A, Tzannes A, Callanan M, Hayes K, Murrell GAC. The Unstable Shoulder in the Adolescent Athlete. Am J Sports Med. 2002;30:758-67, doi: http://journals.sagepub.com/doi/10.1177/03635465020300052401.
Milewski MD, Nissen CW. Pediatric and adolescent shoulder instability. Clin Sports Med. 2013;32:761-79, http://dx.doi.org/10.1016/j.csm.2013.07.010.
Hovelius L. Anterior dislocation of the shoulder in teenagers and young adults. Five-year prognosis. J Bone Joint Surg Am. 1987;69:393-9, doi:http://www.ncbi.nlm.nih.gov/pubmed/2434509.
Zaremski JL, Galloza J, Sepulveda F, Vasilopoulos T, Micheo W, Herman DC. Recurrence and return to play after shoulder instability events in young and adolescent athletes?: a systematic review and meta-analysis. J Sport Med. 2017;51:177-84.
Ochoa-Del-Portillo G, Delgado-Montañez LF, Jimenez-Ospino PA, Rozo Avellaneda DJ. Luxación Voluntaria de Hombro en el Niño. Reporte de Dos Casos. Rev Col Or Tra. 2021;35:169-79, http://dx.doi.org/10.1016/j.rccot.2021.02.009.
Lawton RL, Choudhury S, Mansat P, Cofield RH, Stans AA. Pediatric shoulder instability: Presentation, findings, treatment, and outcomes. J Pediatr Orthop. 2002;22:52-61.
Blackman AJ, Krych AJ, Kuzma SA, Chow RM, Camp C, Dahm DL. Results of revision anterior shoulder stabilization surgery in adolescent athletes. Arthrosc - J Arthrosc Relat Surg. 2014;30:1400-5, http://dx.doi.org/10.1016/j.arthro.2014.05.037.
Nixon MF, Keenan O, Funk L. High recurrence of instability in adolescents playing contact sports after arthroscopic shoulder stabilization. J Pediatr Orthop Part B. 2015; 24:173-7.
Castagna A, Delle Rose G, Borroni M, De Cillis B, Conti M, Garofalo R, et al. Arthroscopic stabilization of the shoulder in adolescent athletes participating in overhead or contact sports. Arthrosc - J Arthrosc Relat Surg. 2012;28:309-15, http://dx.doi.org/10.1016/j.arthro.2011.08.302.
