Shoulder instability: Management current concepts
DOI:
https://doi.org/10.1016/j.rccot.2016.07.007Keywords:
instability, joint, shoulder, management, treatment, arthroscopic, surgeryAbstract
It is known that shoulder is the structure in the body with the highest range of motion, property that ironically makes it more susceptible to dislocations, which is a major challenge for orthopedists. Shoulder dislocation has an incidence of 11.2/100,000 people per year, with a prevalence of 2% in general population. Traumatic dislocation is the main cause of first episode of anterior shoulder dislocation in 95% of the patients, while the posterior dislocation is 2-4% of all gleno-humeral dislocations.
There are data reporting the incidence in the American population between 8.2 and 23.9/100,000 people per year. The distribution of shoulder dislocation has been presented in a particular way with population peaks in the second and sixth decades of life. There are two ways to manage this kind of situations, conservatively or surgically, for surgery there are two management options: open or closed (arthroscopic). With regard to conservative management the traditional technique is immobilization with sling or brace in a neutral position for 2-4 weeks after reduction, when we are in the presence of a dislocation that requires rapid start of movements at rest as well as assisted in order to rehabilitate the patient. Currently there are several tools to assess the quality of life following any shoulder procedure. It is worth mentioning WOSI scale which specifically evaluates the quality of life in patients with a history of shoulder instability.
Evidence Level: IV.
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