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Muscles of the Shoulder

Muscles of the Shoulder

The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...

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Measuring 3D In-vivo Shoulder Kinematics using Biplanar Videoradiography

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Published on: March 12, 2021

Pediatric and Adolescent Shoulder Instability.

Jeffrey Kay^1,2,3,4, Benton E Heyworth^5,6,7, Matthew D Milewski^5,6,7

¹Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA. jeffrey.kay@medportal.ca.

Current Reviews in Musculoskeletal Medicine

|April 17, 2023

Summary

This summary is machine-generated.

Pediatric shoulder instability management varies. Arthroscopic Bankart repair shows success, but recurrence is higher in younger patients or those with prior dislocations. Multidirectional instability (MDI) often responds to physical therapy, with surgery considered for persistent symptoms.

Keywords:

Adolescent Bankart Glenohumeral Instability Pediatric Shoulder

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Area of Science:

Orthopedic Surgery
Pediatric Sports Medicine
Shoulder Biomechanics

Background:

Shoulder instability is prevalent in pediatric and adolescent populations.
Young patients with anterior shoulder dislocation face a high risk of recurrence.
Management strategies for anterior instability and multidirectional instability (MDI) in this age group are critical.

Purpose of the Study:

To review current literature on managing anterior shoulder instability and MDI in pediatric and adolescent patients.
To assess the effectiveness of various surgical and non-surgical treatment options.
To identify factors influencing recurrence rates and outcomes.

Main Methods:

Systematic review of current literature on pediatric and adolescent shoulder instability.
Analysis of outcomes for arthroscopic Bankart repair, Latarjet procedure, and capsulorrhaphy.
Evaluation of non-surgical management for MDI, including physical therapy.

Main Results:

Arthroscopic Bankart repair yields excellent outcomes, but recurrence is higher in those under 16, with prior dislocations, or Hill-Sachs lesions.
The Remplissage procedure may reduce recurrence in cases with large Hill-Sachs lesions.
Open procedures like Latarjet and bony glenoid augmentation are options for significant bone loss or failed primary surgery.
Multidirectional instability (MDI) is common in hyperlaxity and gymnasts/swimmers, with physical therapy being the primary treatment.
Surgical capsulorrhaphy (open or arthroscopic) offers good outcomes for MDI cases refractory to conservative management.

Conclusions:

Careful selection of surgical timing and technique is crucial for preventing recurrent anterior shoulder instability.
While non-surgical treatment is effective for most MDI cases, surgical intervention provides good results for persistent symptoms.
Outcomes for pediatric and adolescent shoulder stabilization are generally positive, with specific considerations for patient factors and injury patterns.