Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population

Area of Science:

• Orthopedics
• Sports Medicine
• Pediatric Surgery

Background:

• Shoulder instability in young patients is multifactorial, involving trauma, ligamentous laxity, and muscle activity.
• Varied nomenclature and complex etiology complicate literature interpretation.

Purpose of the Study:

• To review current literature on pediatric and adolescent shoulder instability.
• To clarify epidemiology, clinical presentation, imaging, and management strategies.

Main Methods:

• Systematic review of existing literature on pediatric and adolescent shoulder instability.
• Analysis of epidemiological data, clinical findings, diagnostic imaging, and treatment outcomes.

Main Results:

• Structural abnormalities post-dislocation are rare in pre-pubertal children.
• Post-pubertal adolescents with traumatic instability and structural damage have a high failure rate with non-operative management.
• Remplissage and Latarjet procedures are options for high-risk adolescents, but side effects need consideration.
• Generalized ligamentous laxity responds best to physiotherapy; arthroscopic plication is a last resort.
• Muscle patterning pathology requires neuromuscular control rehabilitation, not surgery.

Conclusions:

• Management of pediatric and adolescent shoulder instability must be individualized based on etiology.
• Early surgical stabilization is recommended for specific adolescent cases with traumatic instability and structural abnormalities.
• Non-operative and surgical options exist for different subtypes, emphasizing tailored rehabilitation and procedural considerations.