- See: anterior instability
- Discussion:
- characterized by dislocation occuring after minor trauma, relative ease of relocation, and evidence of multidirectional instability;
- this condition is often present in overhead throwing athletes;
- it may lead to thoracic outlet syndrome (dead arm syndrome);
- causes:
- fracture of both the glenoid rim and the greater tuberosity
- fracture of the glenoid rim
- concomitant rotator cuff tear
- patients w/ a neurological deficit
- abnormal glenoid version
- abnormal humeral version
- Hill-Sachs lesion
- Physical Exam:
- sulcus sign is often seen in pts with multidirectional instability;
- look for prominent depression below acromion when inferior traction is applied to wrist;
- integrity of the rotator interval capsule can be confirmed by a lessening of the sign on external rotation of the shoulder
- Surgical Treatment:
- arthroscopic reconstruction
- remplissage
- The Effect of the Remplissage Procedure on Shoulder Stability and Range of Motion: An in Vitro Biomechanical Assessment
- Arthroscopic Bankart repair combined with remplissage technique for the treatment of anterior shoulder instability with engaging Hill-Sachs lesion: a report of 49 cases with a minimum 2-year follow-up.
- Anatomical and functional results after arthroscopic Hill-Sachs remplissage
- A prospective, comparative, radiological, and clinical study of the influence of the "remplissage" procedure on shoulder range of motion after stabilization by arthroscopic Bankart repair
- Arthroscopic remplissage with Bankart repair for the treatment of glenohumeral instability with Hill-Sachs defects
- Outcomes of arthroscopic "remplissage": capsulotenodesis of the engaging large Hill-Sachs lesion.
Redislocation of the shoulder during the first six weeks after a primary anterior dislocation: risk factors and results of treatment.
Failed surgery for recurrent anterior dislocation of the shoulder. Causes and management.
The coracoid transfer for recurrent anterior instability of the shoulder in adolescents.