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. 2013 Sep 6:7:338-46.
doi: 10.2174/1874325001307010338. eCollection 2013.

An overview of shoulder instability and its management

Nicholas Greville Farrar  1 , Joby Jacob George Malal, Jochen Fischer, Mohammed Waseem
Affiliations

An overview of shoulder instability and its management

Nicholas Greville Farrar et al. Open Orthop J. .

Abstract

The assessment and management of patients with instability of the shoulder joint can be challenging, due to the varying ways patients present, the array of different classification systems, the confusing terminology used and the differing potential management strategies. This review article aims to provide a clear explanation of the common concepts in shoulder instability and how they relate to the assessment and management of patients. There are sections covering the mechanisms of shoulder stability, the clinical assessment of patients and imaging techniques. Beyond that there is a discussion on the common classifications systems used and the typical management options. Some patients fall into reasonably well defined categories of classification and in these cases, the management plan is relatively easy to define. Unfortunately, other patients can elude simple classification and in these instances their management requires very careful consideration. Further research may help to facilitate a better understanding of management of the patients in this latter group.

Keywords: Shoulder; dislocation; instability; shoulder arthroscopy; subluxation..

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Figures

Fig. (1a)
Fig. (1a)
This AP radiograph of the shoulder demonstrates a typical anterior dislocation.
Fig. (1b)
Fig. (1b)
This scapula ‘Y’ view confirms the findings from figure xa.
Fig. (2)
Fig. (2)
A Bankart lesion can be seen on this slice from an MR arthrography of the shoulder. Contrast can be seen between the detached anterior labrum and the glenoid.
Fig. (3)
Fig. (3)
This MRI scan of the shoulder demonstrates a posterior bony defect of the humeral head (Hill-Sachs lesion).
Fig. (4)
Fig. (4)
The Stanmore classification system of shoulder instability.
Fig. (5)
Fig. (5)
Radiographs demonstrating the position of the transferred coracoid process after a Latarjet procedure.
Fig. (6)
Fig. (6)
A large posterior Hill-Sachs defect of the humeral head.
Fig. (7)
Fig. (7)
Sutures have been passed through the posterior capsule from anchors placed into the humeral head as part of a ‘Remplissage’ procedure. Once these sutures are tied, the posterior capsule will fill the defect.
Fig. (8)
Fig. (8)
A humeral avulsion of the gleno-humeral ligament (HAGL) lesion seen on a sagittal slice from an MR arthrogram of the shoulder.
See this image and copyright information in PMC

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