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Injuries associated with traumatic anterior glenohumeral dislocations
C M Robinson1, N Shur, T Sharpe
1The Edinburgh Shoulder Clinic, Royal Infirmary of Edinburgh, Little France, Old Dalkeith Road, Edinburgh EH16 4SU, UK. c.mike.robinson@ed.ac.uk
The Journal of Bone and Joint Surgery. American Volume
|January 6, 2012
Summary
Anterior glenohumeral dislocations frequently involve associated injuries like rotator cuff tears or neurological deficits. Older females experiencing low-energy falls are at higher risk for these combined injuries.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Sports Medicine
Background:
- Anterior glenohumeral dislocations can lead to various shoulder girdle injuries.
- Prevalence of neurological deficits, greater tuberosity fractures, and rotator cuff injuries in these dislocations requires further evaluation.
Purpose of the Study:
- To assess the prevalence of neurological deficits, rotator cuff tears, and greater tuberosity fractures in patients with traumatic anterior glenohumeral dislocation.
- To identify risk factors associated with these injuries.
Main Methods:
- Prospective trauma database analysis of 3633 patients with anterior glenohumeral dislocation (1995-2009).
- Assessment of ultrasound-proven rotator cuff tears, tuberosity fractures, and neurological deficits.
- Statistical analysis to determine prevalence and risk factors.
Main Results:
- 13.5% of patients experienced neurological deficits, and 33.4% had rotator cuff tears or greater tuberosity fractures.
- Combined injuries occurred in 7.8% of cases.
- Older females (≥60 years) with low-energy falls had increased risk for rotator cuff tears or fractures; neurological deficits were more likely with these injuries (RR 1.9).
Conclusions:
- The prevalence of associated injuries in primary anterior glenohumeral dislocation is higher than previously thought.
- These injuries can occur independently or in combination.
- Older patients and those with rotator cuff or tuberosity injuries require careful evaluation for neurological deficits and vice versa.
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